CT纹理特征对急性缺血性脑卒中患者血管内治疗后首过效应的预测价值分析OA

Objective To evaluate the predictive value of CT texture features for the first-pass effect(FPE)following endovascular treatment(EVT)in patients with acute ischemic stroke(AIS).Methods A total of 230 AIS patients who underwent mechanical thrombectomy(MT)for anterior circulation stroke at Chinese People's Liberation Army General Hospital between June 2022 and December 2024 were included and divided into non-FPE(122 cases)and FPE(108 cases)groups based on FPE occurrence.Non-contrast CT(NCCT)was performed prior to MT,and radiomics features were extracted from thrombus clots.Clinical data,including procedure time and baseline Alberta Stroke Program Early CT Score(ASPECTS),were collected.Multivariate Logistic regression was used to identify factors influencing FPE after MT in AIS patients.Receiver operating characteristic(ROC)curves were plotted to assess the predictive performance of these factors.Results The FPE group had a significantly higher proportion of males,higher baseline ASPECTS,and shorter procedure time compared to the non-FPE group(all P<0.05).Significant differences were observed between the two groups in terms of neighborhood gray tone difference matrix(NGTDM)_Coarseness,gray level run length matrix(GLRLM)_gray level non-uniformity(GLNU),GLRLM_long run low gray level emphasis(LRLGLE),gray level zone length matrix(GLZLM)_zone percentage,GLZLM_short zone emphasis(SZE),GLZLM_long zone emphasis(LZE),and GLZLM_long zone high gray level emphasis(LZHGLE)(all P<0.05).Male gender(OR=1.535),baseline ASPECTS(OR=2.290),GLRLM_LRLGLE(OR=8.201),and GLZLM_zone percentage(OR=1.158)were identified as factors influencing FPE after MT in AIS patients(all P<0.05).The AUCs for GLRLM_LRLGLE and GLZLM_zone percentage were 0.855 and 0.801,respectively.Conclusion Male gender,baseline ASPECTS,GLRLM_LRLGLE,and GLZLM_zone percentage are factors influencing FPE after MT in AIS patients.Among these,GLRLM_LRLGLE and GLZLM_zone percentage show certain predictive value for FPE.CT-based texture features may serve as auxiliary tools for predicting FPE after MT in AIS patients.