Value of Multimodal Computed Tomography Quantitative Analysis for Predicting Early Neurological Deterioration in Acute Ischemic Stroke Patients Undergoing Intravenous Thrombolysis

多模态计算机断层扫描定量分析在预测接受静脉溶栓治疗的急性缺血性卒中患者早期神经功能恶化中的价值

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Abstract

ObjectiveWe aimed to explore the performance of multimodal computed tomography (CT) quantitative analysis for predicting early neurological deterioration in acute ischemic stroke (AIS) patients undergoing intravenous thrombolysis.MethodsData from 100 AIS patients who underwent multimodal CT and intravenous thrombolysis between January 2020 and December 2023 were collected. An END group and a non-END group were set based on the presence and absence of END after treatment.ResultsAmong the 100 AIS patients, 22 developed END after intravenous thrombolysis, accounting for 22.00%. Infarct core volume was positively associated with END (P < .05), whereas ischemic penumbra volume, ASPECTS, and rLMC score showed inverse associations with END (P < .05). In multivariable analysis, infarct core volume independently increased the odds of END, while higher ASPECTS, rLMC scores, and larger penumbra volumes were associated with lower odds of END. The areas under the receiver operating characteristic (ROC) curves of infarct core volume, ischemic penumbra volume, ASPECTS and rLMC score for predicting the occurrence of END in AIS patients receiving intravenous thrombolysis were 0.761, 0.710, 0.726, 0.715 and 0.846, respectively.ConclusionMultimodal CT quantitative indicators like infarct core volume, ischemic penumbra volume, ASPECTS, and rLMC score have independent predictive values for the occurrence of END in AIS patients receiving intravenous thrombolysis, and their combination exhibits the highest predictive value.

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