Claire Boutet1, Laure Rouffiange-Leclair2, Pierre Garnier3, Sara Quenet4, Daphné Delsart5, Jérôme Varvat6, Magali Epinat7, Fabien Schneider8, Jean-Christophe Antoine9, Patrick Mismetti10, Fabrice-Guy Barral11. 1. Department of Radiology, University Hospital of Saint-Etienne, France; Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France. Electronic address: claire.boutet@chu-st-etienne.fr. 2. Department of Radiology, University Hospital of Saint-Etienne, France. Electronic address: laurerouffiange@hotmail.com. 3. Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France; Department of Neurology, University Hospital of Saint-Etienne, France. Electronic address: pierre.garnier@chu-st-etienne.fr. 4. Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France. Electronic address: sara.quenet@chu-st-etienne.fr. 5. Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France; Department of Therapeutic Medicine, CHU Saint-Etienne, Hôpital Nord, Saint-Etienne, France; Inserm, CIE3, F-42055 Saint-Etienne, France. Electronic address: daphne.delsart@hotmail.fr. 6. Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France; Department of Neurology, University Hospital of Saint-Etienne, France. Electronic address: jvarvat@9online.fr. 7. Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France; Department of Neurology, University Hospital of Saint-Etienne, France. Electronic address: magali.epinat@chu-st-etienne.fr. 8. Department of Radiology, University Hospital of Saint-Etienne, France; Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France. Electronic address: fabien.schneider@univ-st-etienne.fr. 9. Department of Neurology, University Hospital of Saint-Etienne, France; Lyon Neuroscience Research Center, INSERM U1028 - CNRS UMR5292, France; EA 4338, Jean Monnet University, Saint-Etienne, France. Electronic address: j.christophe.antoine@chu-st-etienne.fr. 10. Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France; Department of Therapeutic Medicine, CHU Saint-Etienne, Hôpital Nord, Saint-Etienne, France; Inserm, CIE3, F-42055 Saint-Etienne, France. Electronic address: Patrick.mismetti@chu-st-etienne.fr. 11. Department of Radiology, University Hospital of Saint-Etienne, France; Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France. Electronic address: fabrice.guy.barral@univ-st-etienne.fr.
Abstract
PURPOSE: To compare magnetic resonance imaging (MRI) brain feature in cryptogenic stroke patients with patent foramen ovale (PFO), cryptogenic stroke patients without PFO and patients with cardioembolic stroke. MATERIALS AND METHODS: The ethics committee required neither institutional review board approval nor informed patient consent for retrospective analyses of the patients' medical records and imaging data. The patients' medical files were retrospectively reviewed in accordance with human subject research protocols. Ninety-two patients under 60 years of age were included: 15 with cardioembolic stroke, 32 with cryptogenic stroke with PFO and 45 with cryptogenic stroke without PFO. Diffusion-weighted imaging of brain MRI was performed by a radiologist blinded to clinical data. Univariate, Fischer's exact test for qualitative data and non-parametric Wilcoxon test for quantitative data were used. RESULTS: There was no statistically significant difference found between MRI features of patients with PFO and those with cardioembolic stroke (p<.05). Patients without PFO present more corticosubcortical single lesions (p<.05) than patients with PFO. Patients with PFO have more often subcortical single lesions larger than 15mm, involvement of posterior cerebral arterial territory and intracranial occlusion (p<.05) than patients with cryptogenic stroke without PFO. CONCLUSION: Our study suggests a cardioembolic mechanism in ischemic stroke with PFO.
PURPOSE: To compare magnetic resonance imaging (MRI) brain feature in cryptogenic strokepatients with patent foramen ovale (PFO), cryptogenic strokepatients without PFO and patients with cardioembolic stroke. MATERIALS AND METHODS: The ethics committee required neither institutional review board approval nor informed patient consent for retrospective analyses of the patients' medical records and imaging data. The patients' medical files were retrospectively reviewed in accordance with human subject research protocols. Ninety-two patients under 60 years of age were included: 15 with cardioembolic stroke, 32 with cryptogenic stroke with PFO and 45 with cryptogenic stroke without PFO. Diffusion-weighted imaging of brain MRI was performed by a radiologist blinded to clinical data. Univariate, Fischer's exact test for qualitative data and non-parametric Wilcoxon test for quantitative data were used. RESULTS: There was no statistically significant difference found between MRI features of patients with PFO and those with cardioembolic stroke (p<.05). Patients without PFO present more corticosubcortical single lesions (p<.05) than patients with PFO. Patients with PFO have more often subcortical single lesions larger than 15mm, involvement of posterior cerebral arterial territory and intracranial occlusion (p<.05) than patients with cryptogenic stroke without PFO. CONCLUSION: Our study suggests a cardioembolic mechanism in ischemic stroke with PFO.