国际医学放射学杂志2025，Vol.48Issue(3)：256-262,299,8.DOI:10.19300/j.2025.L21927
血栓直方图特征对机械取栓再通及再灌注的预测价值
Histogram characteristics of thrombus predict successful recanalization and reperfusion of patients with mechanical thrombectomy
摘要
Abstract
Objective This study aims to explore the predictive value of thrombus histogram features for successful recanalization and reperfusion after mechanical thrombectomy(MT)in patients with acute ischemic stroke(AIS),and to assess the clinical applicability of these features in preoperative imaging evaluation.Methods We retrospectively collected clinical and imaging data from 98 patients who underwent MT for AIS.All patients underwent non-contrast cranial CT and CT angiography(CTA),and thrombus histogram features such as mean,standard deviation,skewness,and kurtosis were measured from original images using Image J software.Patients were categorized into the successful recanalization group(n=65)and failed recanalization group(n=33)based on the recanalization status,and the successful reperfusion group(n=70)and failed reperfusion group(n=28)based on the reperfusion status.Differences between groups were compared using t-test,Mann-Whitney U test,Chi-square test,and Fisher's exact test.Multivariate logistic regression was used to identify independent predictors,and to establish nomogram models.Calibration curves and decision curve analysis were performed to evaluate model stability and clinical utility.Results Compared with the failed recanalization group,successful recanalization group had a shorter onset time and higher thrombus CTA skewness(both P<0.05).Similarly,there were significant differences in onset time and thrombus CTA skewness between the successful and failed reperfusion groups(both P<0.05).Multivariate logistic regression analysis indicated that onset time and thrombus CTA skewness were independent predictors of both recanalization and reperfusion(both P<0.05).Nomogram models were constructed to predict recanalization and reperfusion based on thrombus CTA skewness and onset time.Calibration curves showed good agreement between the predicted and actual values for recanalization and reperfusion(P=0.862 and 0.831,respectively).Decision curve analysis indicated that the nomogram models had good clinical applicability for predicting recanalization and reperfusion.Conclusion The skewness of thrombus histogram features demonstrates potential predictive value for assessing recanalization and reperfusion status following mechanical thrombectomy,serving as a novel reference indicator in preoperative imaging evaluation that facilitates personalized treatment strategies for AIS.关键词
缺血性卒中/血栓/体层摄影术,X线计算机/直方图/机械取栓/再通/再灌注Key words
Acute ischemic stroke/Thrombus/Tomography,X-ray computed/Histogram/Mechanical thrombectomy/Recanalization/Reperfusion分类
特种医学引用本文复制引用
刘松,付乐君,任涛,孙羽,魏铭,靳松,田超,夏爽..血栓直方图特征对机械取栓再通及再灌注的预测价值[J].国际医学放射学杂志,2025,48(3):256-262,299,8.基金项目
国家自然科学基金面上项目(82171916,81871342) （82171916,81871342）
天津市卫生健康科技项目(TJWJ2022QN061) （TJWJ2022QN061）
