医学
灌注
优势比
烟雾病
阶段(地层学)
改良兰金量表
灌注扫描
内科学
血运重建
心脏病学
冲程(发动机)
缺血
缺血性中风
心肌梗塞
古生物学
工程类
生物
机械工程
作者
Yin Hu,Xingju Liu,Dong Zhang,Yan Zhang,Rong Wang,Meng Zhao,Jizong Zhao
出处
期刊:Stroke
[Ovid Technologies (Wolters Kluwer)]
日期:2018-12-01
卷期号:49 (12): 2837-2843
被引量:37
标识
DOI:10.1161/strokeaha.118.022628
摘要
Background and Purpose- The study goal was to evaluate cerebral perfusion in moyamoya patients with a novel staging system and investigate the association between differences of perfusion status and clinical outcomes in patients treated with revascularization. Methods- About 506 consecutive patients from 2009 to 2015 were enrolled. The perfusion status was evaluated by a staging system-the stage of preinfarction period based on the result of computed tomography perfusion. Hemisphere in different perfusion stage was compared between hemorrhagic patients (n=155) and ischemic patients (n=351). The modified Rankin Scale was applied to evaluate the prognosis of patients. Results- In the enrolled 506 patients: 229 hemispheres (22.6%) with normal perfusion, 72 hemispheres (7.1%) in stage I, 205 hemispheres (20.3%) in stage II, 308 hemispheres (30.4%) in stage III, and 198 hemispheres (19.6%) in stage IV. Significant difference was observed in stage distribution between hemorrhagic patients and ischemic patients ( P<0.01). The ratio of hemispheres with normal perfusion in hemorrhagic group is more than the ischemic group ( P<0.05; odds ratio, 1.440; 95% CI, 1.144-1.811). The ratio of hemispheres in stage III in ischemic group is more than the hemorrhagic group ( P<0.01; odds ratio, 0.618, 95% CI, 0.487-0.783). In the prognosis-related analysis, the stage I group has the highest improved ratio (73.9%) and the normal perfusion group has the lowest improved ratio (33.3%). The improved ratio has a decreasing tendency from stage I to stage IV. Conclusions- The novel preinfarction staging system is a valuable assessment tool to evaluate cerebral perfusion status in moyamoya patients and predict the efficacy of revascularization. Ischemic patients suffer more from hypoperfusion. Patients in stage I and stage II are more likely to obtain improvement after revascularization. This is a retrospective study.
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