Predictive value of cerebral blood volume index in assessing the prognosis of stroke patients with anterior circulation large vessel occlusion in the extended time window after endovascular therapy
NI Wenjing
SHEN Guangchen
YIN Zixin
MA Gao
CHU Yue
LU Shanshan
XU Xiaoquan
WU Feiyun
Abstract：Objective To investigate the predictive value of cerebral blood volume index(CBV Index)for the 90-day neurological outcomes in acute ischemic stroke(AIS)patients with anterior circulation large vessel occlusion in the extended time window(>6 h)after endovascular therapy(EVT).Methods This retrospective study enrolled 137 AIS patients with anterior circulation large vessel occlusion in extended time window after EVT.General clinical data and brain computed tomography perfusion(CTP)images were analyzed.Patients were categorized into two groups based on the modified Rankin Scale(mRS)at 90 days after EVT,defining a good outcome as mRS≤2(60 cases)and a poor outcome as mRS>2(77 cases).Volume of infarct core,CBV Index,hypoperfusion intensity ratio(HIR),and general clinical data were compared between two groups using Mann-Whitney U test,chi-square test or Fisher's exact test.Multivariate Logistic regression analysis was used to construct a prognostic prediction model,and area under the curve(AUC)of receiver operating characteristic(ROC)was used to assess predictive efficiency.Results The good outcome group exhibited lower age,a higher proportion of males,and a lower NIHSS score on admission compared to the poor outcome group(all P<0.05).Additionally,patients with a favorable prognosis had smaller volume of infarct core,successful recanalization,higher CBV Index,and lower HIR(all P<0.05).Logistic regression analysis identified age,NIHSS score on admission,recanalization,and CBV Index as independent predictors of prognosis in AIS patients with anterior circulation large vessel occlusion in the extended time window after EVT(all P<0.05).ROC curve analysis showed that the model integrating age,NIHSS score on admission,recanalization,and CBV Index had excellent predictive efficiency for prognosis,with an AUC of 0.878,sensitivity of 81.67%,and specificity of 87.01%.Conclusion CBV Index is associated with the 90-day neurological outcome in AIS patients with anterior circulation large vessel occlusion in the extended time window after EVT.The model integrating age,NIHSS score on admission,recanalization,and CBV Index can effectively predict the prognosis.
Keywords：Acute ischemic strokeEndovascular therapyComputed tomography perfusionCerebral blood volume index
Publication Date：2024-03-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 148-153 )