Prognostic Efficacy of Plain CT Scan in Vascular Recanalization after Treatment of Acute Cerebral Infarction Caused by Cerebral Artery Thrombosis

WANG Ting; DONG Jian; GU Xuecun; SHI Guang; HOU Qing

doi:10.3969/j.issn.1002-3429.2024.19.010

Abstract：Objective To investigate the predictive efficacy of plain CT scan in vascular recanalization after treatment of acute cerebral infarction(ACI)caused by cerebral artery thrombosis.Methods A retrospective study was conducted on 80 patients with ACI caused by cerebral artery thrombosis treated from January 2021 to December 2023.According to the suc-cess of vascular recanalization after intravenous thrombolysis,the patients were divided into a successful group(n=44)and an unsuccessful group(n=36).Baseline data,plain CT scan results,National Institutes of Health Stroke Scale(NIHSS)score before and after treatment and improvement rate of the two groups were compared to analyze the influence of plain CT scan results on vascular recanalization after treatment and its predictive efficacy.Results The time from onset to thrombolysis in unsuccessful group was longer than that in successful group,and the proportion of patients who had no history of antiplatelet drug use was higher than that in successful group(P＜0.01).The NIHSS score of unsuccessful group was higher than that of successful group before and after treatment,while the improvement rate of NIHSS score was lower than that of successful group(P＜0.01).The CT value of thrombus in the unsuccessful group was lower than that in the successful group,while the pro-portion of target vessels with equal/low density and infarct volume were greater than those in the successful group(P＜0.01).The CT value of thrombus,manifestations of target vessels and infarct volume were negatively correlated with the improvement rate of NIHSS score in the two groups(P＜0.01).Logistic regression analysis showed that CT value of thrombus,target ves-sel with equal/low density and infarct volume were independent factors for unsuccessful vascular recanalization in ACI patients after treatment(P＜0.01).The analysis of receiver operating characteristic(ROC)curve showed that the area under the ROC curve(AUC)of the combined prediction of CT value of thrombus,target vessel with equal/low density,and infarct vol-ume was 0.932,which was greater than that predicted by the three alone(P＜0.05),with the sensitivity of 86.36%and the specificity of 86.11%.Conclusion CT value of thrombus,target vessels with equal/low density,and infarct volume are re-lated to vascular recanalization after intravenous thrombolysis in ACI patients caused by cerebral artery thrombosis.The param-eters of plain CT scan can be used as effective indicators to predict vascular recanalization and provide decision-making basis for clinical treatment.