% 0期刊文章%一个约瑟夫Benzakoun Basile Kerleroux % % Cyril Dargazanli凯文Janot % %迪米特里戴利Eraya % Wagih本•%一个让-弗朗索瓦•朱本杰明血淋淋的% %(%一个丽丽Detraz Charline佩罗% %一个Romain Bourcier % Rouchaud Aymeric %一个高提耶弗赖斯节Geraud % Marnat %一个Pasquale Mordasini弗洛伦特·Gariel % %一个Guillaume Turc皮埃尔Seners % %一个凯瑟琳·奥本海姆Johannes Kaesmacher % %一个格雷戈勒Boulouis Olivier Naggara % %代表JENI研究协作% T相关大脑区域的口才评估患者的一大核心机械血栓切除术治疗缺血性% D R 10.1212 / WNL 2021%。0000000000012863 % J首页神经病学% P e1975-e1985 % V 97% N 20% X目的个性化的病人选择机械血栓切除术(MT)在急性缺血性中风患者(AIS)和大型缺血性核心(LIC)基线是一个未满足的需求。我们测试的假设评估梗塞的和hypoperfused脑组织的功能相关性将改善患者的选择框架LIC MT.Methods我们进行了多中心回顾性研究与地方政府投资公司的成年人(缺血性核心数量> 70毫升MRI diffusion-weighted成像)与核磁共振灌注治疗MT或最佳医疗管理(BMM)。主要结果是三个月改良Rankin规模(夫人),如果0 - 3有利。全球和区域eloquence-based核心灌注率不匹配。临床结果的预测准确性雄辩的地区参与比较多变量和引导随机森林模型。结果共有138名患者基线LIC包括(太n = 96或BMM n = 42;平均年龄±SD, 72.4±14.4年;34.1%的女性;0 - 3夫人:45.1%)。意思是核心和关键hypoperfused体积是100.4毫升±36.3毫升,157.6±56.2毫升,分别和组之间没有差别。模型考虑的功能相关性梗塞位置显示一个更好的预测准确性的夫人0 - 3 c统计的0.76和0.83为逻辑回归模型和随机森林引导测试集,分别。 In these models, the interaction between treatment effect of MT and the mismatch was significant (p = 0.04). In comparison, in the logistic regression model disregarding functional eloquence, the c statistic was 0.67 and the interaction between MT and the mismatch was insignificant.Conclusions Considering functional eloquence of hypoperfused tissue in patients with a large infarct core at baseline allows for a more precise estimation of treatment expected benefit.Classification of Evidence This study provides Class II evidence that, in patients with AIS and LIC, considering the functional eloquence of the infarct location improves prediction of disability status at 3 months.ADC=apparent diffusion coefficient; aEF=adjusted effect; AIC=acute ischemic stroke; aOR=adjusted odds ratio; ASPECTS=Alberta Stroke Program Early CT Score; BMM=best medical management; DWI=diffusion-weighted imaging; E-MR=eloquent mismatch ratios; G-I=global infarct volume; G-MR=global mismatch ratio; HE=brain regions with high eloquence; HE-I=high-eloquence infarct; HE-MR=high-eloquence mismatch radio; HE-P=high-eloquence critically hypoperfused tissue (i.e., penumbra); ICA=internal carotid artery; LIC=large ischemic core; LVO=large vessel occlusion; MNI=Montreal Neurological Institute; mRS=modified Rankin Scale; MT=mechanical thrombectomy; NNT=number needed to treat; SIT-uv=severely ischemic tissue of uncertain viability; tPA=tissue plasminogen activator; VLSM=voxel-based lesion symptom mapping %U //www.ez-admanager.com/content/neurology/97/20/e1975.full.pdf