TY -的T1 -相关的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JF -神经学乔-神经病学SP - e1975 LP - e1985做- 10.1212 / WNL。首页0000000000012863六世- 97 - 20盟Basile Kerleroux AU -约瑟夫Benzakoun AU -凯文Janot盟西里尔Dargazanli AU -迪米特里戴利Eraya盟Wagih本•盟让-弗朗索瓦•朱盟-本杰明血淋淋的AU -弗朗索瓦(AU - Charline佩罗盟丽丽Detraz AU -罗曼·Bourcier盟Rouchaud Aymeric AU -弗赖斯节Geraud盟高提耶Marnat AU -弗洛伦特·Gariel盟Pasquale Mordasini AU -皮埃尔Seners盟Guillaume Turc AU -约翰Kaesmacher盟凯瑟琳奥本海姆AU - Olivier Naggara AU -格雷戈勒Boulouis盟代表JENI研究协作Y1 - 2021/11/16 UR - //www.ez-admanager.com/content/97/20/e1975.abstract N2 -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。首页我们测试评估的功能相关性的假设和梗塞的hypoperfused脑组织会提高患者的选择框架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(缺血性核心体积在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。 Models considering the functional relevance of the infarct location showed a better accuracy for the prediction of mRS 0–3 with a c statistic of 0.76 and 0.83 for logistic regression model and bootstrap random forest testing sets, respectively. 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 ER -