Zhongguo linchuang yanjiu (Jul 2024)
The predictive value of whole brain CT perfusion imaging and serum MMP-9 level in hemorrhagic transformation after acute cerebral infarction
Abstract
"Objective To explore the value of whole brain CT perfusion (CTP) imaging parameters and serum MMP-9 level in predicting hemorrhagic transformation (HT) after endovascular therapy of acute cerebral infarction (ACI). Methods A retrospective study was conducted on 46 patients with ACI who underwent endovascular stent mechanical thrombectomy in Wuhan No.1 Hospital from June 2021 to September 2022. Routine CT plain scan, CTP, and serum MMP-9 examination were performed before endovascular treatment, and the symmetrical site ratio between the affected side and the unaffected side of CTP was calculated to obtain the relative parameter values: relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), relative mean transit time (rMTT), relative time to peak (rTTP) and relative permeability surface (rPS). According to whether the CT images re-examined within 7 days of treatment had HT, the patients were divided into HT group and non-HT group. Spearman rank correlation analysis was used to analyze the correlation of HT with CTP parameters and serum MMP-9 level, and to evaluate the predictive efficacy of the two indexes on HT after endovascular treatment of ACI. Results Of the 46 patients, HT occurred in 12 patients and non-HT in 34 patients. Compared with non-HT group, rCBV and rCBF decreased,while rPS, PS, rTTP and MMP-9 increased in HT group (P＜0.05). However, there was no statistically significance of rMTT between the two groups (P＞0.05). rPS, PS, rTTP and MMP-9 were positively correlated with HT (P＜0.01), and rCBV and rCBF were negatively correlated with HT (P＜0.01), respectively.Among them, MMP-9 was most strongly correlated with HT (r=0.752,P＜0.01), followed by rPS (r=0.664,P＜0.01). The area under curve (AUC) of rCBV, rCBF, rTTP, PS, rPS and MMP-9 in predicting HT was 0.794, 0.755, 0.750, 0.848, 0.936 and 0.863, respectively, with rPS being the highest. Conclusion The changes in CTP parameters and the increase of serum MMP-9 level are of great significance in predicting the HT after endovascular treatment of ACI, which can provide a guidance for endovascular treatment of patients."
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