| 赵丹,陆科夫,刘文龙,蒋明坤,李岚,胡蓉.CT血管成像脑皮质静脉显影评分预测急性缺血性脑卒中经血管内治疗后出血转化[J].中国医学影像技术,2026,42(5):667~671 |
| CT血管成像脑皮质静脉显影评分预测急性缺血性脑卒中经血管内治疗后出血转化 |
| Cortical vein opacification score based on CT angiography for predicting hemorrhagic transformation after endovascular treatment of acute ischemic stroke |
| 投稿时间：2026-02-28 修订日期：2026-05-11 |
| DOI：10.13929/j.issn.1003-3289.2026.05.003 |
| 中文关键词: 缺血性脑卒中 体层摄影术,X线计算机 血管内治疗 |
| 英文关键词:ischemic stroke tomography, X-ray computed endovascular treatment |
| 基金项目:贵州省中医药管理局中医药、民族医药科学技术研究课题(QZYY-2023-144)。 |
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| 中文摘要: |
| 目的 观察CT血管成像(CTA)脑皮质静脉显影评分(COVES)预测急性缺血性脑卒中(AIS)经血管内治疗(EVT)后出血转化(HT)的价值。方法 回顾性分析接受EVT及治疗前基于CTA COVES和Tan评分的240例AIS患者,根据治疗后24~72 h头颅CT分为HT组(n=94)与非HT组(n=146)。采用多因素logistic回归分析筛选EVT后HT的独立影响因素;以受试者工作特征曲线下面积(AUC)比较COVES和Tan评分的预测效能。结果 美国国立卫生研究院卒中量表(NIHSS)高评分和高中性粒细胞与淋巴细胞比值(NLR)均为AIS EVT后HT的独立危险因素,高COVES及高Tan评分则为其独立保护因素(P均＜0.05)。COVES预测AIS EVT后HT的AUC为0.844,高于Tan评分的0.776(P＜0.05)。结论 CTA COVES用于预测AIS EVT后HT具有良好效能。 |
| 英文摘要: |
| Objective To observe the value of cortical vein opacification score (COVES) based on CT angiography (CTA) for predicting hemorrhagic transformation (HT) after endovascular treatment (EVT) of acute ischemic stroke (AIS). Methods A total of 240 AIS patients who underwent EVT and CTA before EVT for COVES and Tan scoring were retrospectively enrolled and divided into HT group (n=94) and non-HT group (n=146) according to head CT 24—72 h after treatment. Multivariate logistic regression analysis was used to identify independent impact factors of HT after EVT. The area under the receiver operating characteristic curve (AUC) was used to evaluate the predictive performance of COVES and Tan scores. Results Higher National Institutes of Health stroke scale (NIHSS) score and higher neutrophil-to-lymphocyte ratio (NLR) were both independent risk factors, whereas higher COVES and higher Tan scores were both independent protective factors of HT in AIS patients after EVT (all P＜0.05). The AUC of COVES for predicting HT in AIS patients after EVT was 0.844, superior to that of Tan score (0.776, P＜0.05). Conclusion COVES based on CTA exhibited good efficacy for predicting HT in AIS patients after EVT. |
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