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Wang L, Tian G, Zhang H, Chen J, Sun Z, Guo F et al . Prognostic value of CT perfusion imaging, serum D-D and MMP-9 on hemorrhage transformation after thrombolysis in patients with acute cerebral infarction. Int J Radiat Res 2024; 22 (3) :711-717 URL: http://ijrr.com/article-1-5653-en.html
Department of Imaging Diagnosis, Inner Mongolia Medical University Affiliated Hospital, Hohhot, China , shenjie_319@126.com
Abstract: (1054 Views)
Background: This study explores the predictive value of Computerized Tomography (CT) perfusion imaging, serum D-dimer (D-D), and serum matrix metalloproteinase-9 (MMP-9) levels for hemorrhagic transformation (HT) in patients with acute cerebral infarction post-thrombolysis. Materials and Methods: Patients with acute cerebral infarction who underwent thrombolytic therapy from February 2021 to February 2022 were included. CT perfusion imaging was conducted within a week post-operation. The study compared CT perfusion parameters and serum markers, analyzing differences and conducting univariate and multivariate analyses to explore their predictive value for HT. Results: No significant differences were found in hypertension, hyperlipidemia, stroke history, mean arterial pressure, fasting blood glucose, and platelet count pre-thrombolysis (P > 0.05). However, infarct diameter ≥ 5 cm and atrial fibrillation were more common in the study group, with higher pre-thrombolysis National Institutes of Health Stroke Scale (NIHSS) score, D-D, and MMP-9 levels (P < 0.05). CT perfusion showed lower relative cerebral blood volume (rCBV, relative cerebral blood flow (rCBF, and higher relative mean transit time (rMTT), relative time to peak (rTTP) in the study group (P < 0.05). D-D and MMP-9 levels were negatively correlated with rCBV, rCBF, and positively with rTTP, CTP integration index (P < 0.05). Conclusion: CT perfusion imaging, serum D-D, and MMP-9 levels are effective predictors of hemorrhagic transformation in acute cerebral infarction patients post-thrombolysis. These findings are valuable for guiding clinical treatment and monitoring.
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