RT期刊文章SR电子T1抵押品响应调节time-penumbra关系近端动脉遮挡摩根富林明神经病学神经学乔FD Lippincott Williams &威尔金斯SP e316 OP e322 10.1212 / WNL。首页90签证官0000000000004858是4 A1传承Agarwal A1安德鲁Bivard A1伊丽莎白·沃伯顿A1马克·帕森斯A1克里斯托弗·利年2018 UL //www.ez-admanager.com/content/90/4/e316.abstract AB客观而临床受首页益于溶栓随时间增加中风发作,急性生理组织间的关系和间接应对中风发病时间尚不清楚。方法我们研究连续患者近端动脉遮挡(n = 355)与全脑灌注CT造影CT发病6小时内的。半影和核心是使用分布定义阈值。组织不匹配被定义为模糊核心的比率。抵押品分数评估使用之前验证视觉评分。结果意味着(SD)是72.1(12.4)岁,中位数(四分位范围)NIH卒中量表评分16(4),平均(SD)成像时间152.5(69.7)分钟。半影卷(枪兵ρ= 0.119,p = 0.026)和不匹配(斯皮尔曼ρ= 0.115,p = 0.030)发生的时间。核心体积减少(斯皮尔曼ρ=−0.112,p = 0.035),抵押品分数随时间增加(斯皮尔曼ρ= 0.117,p = 0.028)。在多变量回归,好抵押品分数预测长时间以来出现(β= 0.101,p = 0.039),而不是预测不匹配(β= 0.001,p = 0.351)。良好的抵押品评分是最强的独立预测指标的最终梗死体积和提高临床赤字。Conclusions In our large patient cohort study of proximal arterial occlusions, we found an incremental collateral response and preserved penumbral volume with time. Thus, tissue viability can be maintained in this time window (0–6 hours) after stroke if leptomeningeal collaterals are able to sustain the penumbra. Our findings suggest that a longer therapeutic window may exist for intra-arterial intervention and that multimodal imaging may have a role in strokes of unknown onset time.AUC=area under the curve; CBF=cerebral blood flow; CBV=cerebral blood volume; CTA=CT angiography; DWI=diffusion-weighted imaging; FLAIR=fluid-attenuated inversion recovery; ICA=internal carotid artery; MCA=middle cerebral artery; MIP=maximum image projection; NCCT=noncontrast CT; NIHSS=NIH Stroke Scale; ROC=receiver operating characteristic