Predictive value of multimodal CT imaging for early neurological deterio-ration in patients with acute ischemic stroke after intravenous thromboly-sis
Objective To investigate the predictive value of multimodal CT imaging for early neurological deterioration(END)in patients with acute ischemic stroke(AIS)after intravenous thrombolysis.Methods Clinical data of 131 AIS patients received intravenous thrombolysis treatment at Stroke Center of Yancheng Traditional Chinese Medicine Hospital in Jiangsu Province and Yancheng Third People's Hospital in Jiangsu Province from March 2018 to September 2022 were retrospectively analyzed.According to whether END occurred,they were divided into the non-END group(110 cases)and the END group(21 cases).Clinical data of the two group were compared,and the influencing factors of multimodal CT imag-ing indexes on the occurrence of END after intravenous thrombolysis in AIS patients were analyzed.Receiver operator characteristic(ROC)curve was used to predict the diagnostic value of multimodal CT imaging indexes for the occurrence of END after intravenous thrombolysis in AIS patients.Results Alberta stroke program early CT score,region leptomeningel collateral(rLMC)score in the END group were lower than those in the non-END group,infarct core volume,low perfusion volume,and ischemic penumbra volume in the END group were larger than those in the non-END group,the bleeding rate after 24 hours of thrombolysis in the END group was higher than that in the non-END group,and the differences were statistically significant(P＜0.05).After correction for age,sex,body mass index,smoking,hypertensive disease,diabetes mellitus,atrial fibril-lation,admission NIHSS score,admission-to-treatment time,and the bleeding rate after 24 hours of thrombolysis,rLMC score(OR=0.61),infarct core volume(OR=1.04),low perfusion volume(OR=1.02),and ischemic penumbra volume(OR=1.01)were the influencing factors for the occur-rence of END after intravenous thrombolysis in AIS patients(P＜0.05).ROC curve analysis showed that area under the curve of low perfusion vol-ume predicted the occurrence of END after intravenous thrombolysis in AIS patients was the highest,and ischemic penumbra volume was the low-est.Conclusion RLMC score,low perfusion volume,infarct core volume,and ischemic penumbra volume have independent predictive value for the occurrence of END after intravenous thrombolysis in AIS patients..
NETL
NSTL
万方数据
