Purpose

Thrombus features on admission CT are useful imaging markers for clot characterization, stroke pathogenesis and outcome prediction. In this context, thrombus perviousness is a promising parameter, but reliable assessment in daily clinical practice is demanding. The aim of the present study was to evaluate an easy to assess measuring method for thrombus permeability at the time of admission.

Methods

The CTA-index, which measures relative thrombus attenuation on admission CTA, was compared to the known perviousness parameter in a cohort of 101 patients with large-vessel occlusions of the middle cerebral artery and correlated to clinical outcome parameters (mRS after 90 days, ≤2 rated as favorable). For validation, this correlation was tested in a second independent cohort (n = 87), and possible associations between the CTA-index and outcome measurements (NIHSS/mRS/mTICI) were assessed.

Results

In the first cohort a coherence between conventional perviousness measurements and the CTA-index was shown. The CTA-index differed significantly between favorable (−0.55 ± 0.16) and non-favorable outcomes (−0.64 ± 0.14, p = 0.01). In the validation cohort this result could be independently reproduced (−0.52 ± 0.13/−0.70 ± 0.09, p < 0.01). The CTA-index showed an association with low NIHSS at discharge (p < 0.01), favorable outcome after 90 days (p < 0.001) and with better reperfusion (measured by mTICI score, p = 0.04).

Conclusion

The CTA-index is an easy to assess imaging parameter on admission CTA in the acute stroke phase and is associated with angiographic and clinical outcome. It can be considered as a simplified measuring method for thrombus perviousness, which is known to provide useful information for further stroke progress and clinical course as well as therapeutic and rehabilitative decisions.

中文翻译：

---

引入 CTA 指数作为血栓透过性的简化测量方法

目的

入院时的血栓特征 CT 是凝块表征、中风发病机制和结果预测的有用成像标志物。在这种情况下，血栓渗透率是一个很有前途的参数，但在日常临床实践中进行可靠的评估是很重要的。本研究的目的是评估一种易于评估的入院时血栓通透性测量方法。

方法

测量入院 CTA 时相对血栓衰减的 CTA 指数与一组 101 名大脑中动脉大血管闭塞患者的已知渗透性参数进行比较，并与临床结果参数相关（90 天后的 mRS，≤ 2 评为好评）。为了验证，在第二个独立队列 ( n = 87)中测试了这种相关性 ，并评估了 CTA 指数和结果测量 (NIHSS/mRS/mTICI) 之间的可能关联。

结果

在第一个队列中，显示了常规渗透性测量和 CTA 指数之间的一致性。CTA 指数在有利（-0.55 ± 0.16）和不利结果（-0.64 ± 0.14， p  = 0.01）之间存在显着差异。在验证队列中，该结果可以独立重现（-0.52 ± 0.13/-0.70 ± 0.09，p  < 0.01）。CTA 指数显示出院时 NIHSS 低（p  < 0.01）、90 天后的良好结果（p  < 0.001）和更好的再灌注（通过 mTICI 评分衡量，p  = 0.04）。

结论

CTA 指数是在急性卒中期入院 CTA 时易于评估的成像参数，并且与血管造影和临床结果相关。它可以被认为是血栓渗透性的简化测量方法，已知它可以为进一步的中风进展和临床过程以及治疗和康复决策提供有用的信息。