Khảo sát mối tương quan giữa các thể tích tmax và kết cục lâm sàng trên bệnh nhân nhồi máu não tuần hoàn trước

Abstract

Objective: To analyze the correlation between pre-treatment Tmax volumes in MRI perfusion with functional outcome after thrombectomy. Subjects and methods: 316 consecutive patients with middle cerebral artery occlusion or internal carotid occlusion treated with mechanical thrombectomy in the window 6-24 hours were included from January 2024 to July 2025. Tmax volumes at delays of  > 4s, 6s, 8s, and 10s and mismatch ratio were automatically calculated in preinterventional MRI perfusion using RAPID software. Outcome was assessed using modified Rankin scale at 90 days. Statistical analyses were performed using SPSS 20.0. Results: In patients with successful recanalization of MCA occlusion, Tmax at delays 10s, 8s, 6s showed the positive correlation with clinical outcome (r = 0.57; p=0.001, r = 0.56; p=0.002, r = 0.52; p=0.002 respectively). In ICA occlusions, only Tmax at delay 10s and 8s showed a significant correlation with clinical outcome Conclusion: Tmax  at delays at 10s, 8s, and 6s have a moderate correlation with clinical outcome in MCA occlusions. In ICA occlusions, however, only Tmax volumes at delay 10s and 8s have significant correlation with mRS at 90 days. The multivariable logistic regression analysis demonstrated Tmax >4s volume independently associated with mRS 90 days, even after adjustment for important clinical and imaging variables such as ASPECTS and 24-hour NIHSS (OR = 0.993; 95% CI: 0.988 - 0.998; p=0.007).