Non-contrast CT findings of acute ischemic stroke for predicting early prognosis after mechanical thrombectomy
10.13929/j.issn.1672-8475.2024.08.003
- VernacularTitle:急性缺血性脑卒中平扫CT表现预测机械取栓后早期预后
- Author:
Jingyao YANG
1
;
Yeyu XIAO
;
Qian ZHANG
;
Fangfang DENG
;
Zhuyin ZHANG
;
Jianjun PAN
;
Qinghua LUO
;
Haiyang DAI
Author Information
1. 广州中医药大学附属广州中西医结合医院放射科,广东 广州 510800
- Keywords:
stroke;
tomography,X-ray computed;
embolectomy;
prognosis;
nomograms
- From:
Chinese Journal of Interventional Imaging and Therapy
2024;21(8):457-462
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of non-contrast CT findings of acute ischemic stroke(AIS)for predicting early prognosis after mechanical thrombectomy.Methods Data of 161 AIS patients from clinical center 1 who underwent mechanical thrombectomy were retrospectively analyzed.The patients were divided into training set(n=113)and internal test set(n=48)at the ratio of 7∶3,while 79 AIS patients who underwent mechanical thrombectomy from clinical center 2 were retrospectively enrolled as external test set.According to the National Institutes of Health stroke scale(NIHSS)scores 7 days after thrombectomy,patients'prognosis were classified as good(＜15 points)or poor(≥15 points).Pre-treatment non-contrast CT images of patients were reviewed,and CT findings were comparatively analyzed.Independent predictors of patients'early prognosis after mechanical thrombectomy were obtained with sequential univariate and multivariate logistic regressions,and a predicting model was established and visualized as a nomogram.The receiver operating characteristic curve was drawn,and the distinction was assessed with the area under the curve(AUC),then calibration was assessed with Hosmer-Lemeshow goodness of fit test,and the net benefit was evaluated with decision curve analysis(DCA).Results Alberta stroke program early CT score(ASPECTS),hyperdense middle cerebral artery sign(HMCAS)and basal ganglia calcification were all independent predictors of early prognosis of AIS after mechanical thrombectomy(all P＜0.05).The predictive model was established combining the above 3 variables and then visualized as a nomogram to predict prognosis of AIS after mechanical thrombectomy,with AUC of 0.776 in internal test set(χ2=6.052,P=0.417)and 0.800 in external test set(χ2=2.269,P=0.811).DCA showed that the nomogram might provide clinical net benefit within certain threshold probability ranges.Conclusion ASPECTS,HMCAS and basal ganglia calcification were all independent predictors of early prognosis of AIS after mechanical thrombectomy.The nomogram originated from predicting model combining the three could be used to somewhat accurately predict poor early prognosis after mechanical thrombectomy.
