Samuel Emeriau1, Sébastien Soize2, Laurence Riffaud2, Olivier Toubas2, Francis Pombourcq2, Laurent Pierot2. 1. Department of neuroradiology, hôpital Maison-Blanche, CHU de Reims, Reims university, 45, rue Cognacq-Jay, 51092 Reims cedex, France. Electronic address: semeriau@chu-reims.fr. 2. Department of neuroradiology, hôpital Maison-Blanche, CHU de Reims, Reims university, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
Abstract
BACKGROUND: The goal of the present study was to determine whether the presence or absence of parenchymal FLAIR hyperintensity alone, before thrombolysis, might be a predictive factor of ischemic stroke outcomes after the acute phase of stroke and at 3 months. MATERIALS AND METHODS: We retrospectively included 84 patients with an ischemic stroke between November 2007 and March 2012, who underwent 3T MRI, were treated by thrombolysis, and had medical follow-up at 3 months. Two readers analyzed parenchymal FLAIR visibility. Logistic regressions were performed for NIHSS difference (NIHSS at admission - NIHSS at the end of hospitalization) and for 3 months modified Ranking Score (mRS). Predictive values of positive parenchymal FLAIR for identifying poor outcome at discharge and at 3 months were estimated. RESULTS: Parenchymal FLAIR positivity was not predictive of NIHSS difference but it predicted poor outcome at 3 months (sensitivity: 0.49 [0.37-0.60], specificity: 0.69 [0.46-0.91], positive predictive value: 0.87 [0.76-0.98] and negative predictive value: 0.24 [0.12-0.36]). CONCLUSIONS: At 3 Tesla, the presence of a parenchymal hyperintense FLAIR signal before thrombolysis is predictive of a poor clinical outcome at 3 months.
BACKGROUND: The goal of the present study was to determine whether the presence or absence of parenchymal FLAIR hyperintensity alone, before thrombolysis, might be a predictive factor of ischemic stroke outcomes after the acute phase of stroke and at 3 months. MATERIALS AND METHODS: We retrospectively included 84 patients with an ischemic stroke between November 2007 and March 2012, who underwent 3T MRI, were treated by thrombolysis, and had medical follow-up at 3 months. Two readers analyzed parenchymal FLAIR visibility. Logistic regressions were performed for NIHSS difference (NIHSS at admission - NIHSS at the end of hospitalization) and for 3 months modified Ranking Score (mRS). Predictive values of positive parenchymal FLAIR for identifying poor outcome at discharge and at 3 months were estimated. RESULTS: Parenchymal FLAIR positivity was not predictive of NIHSS difference but it predicted poor outcome at 3 months (sensitivity: 0.49 [0.37-0.60], specificity: 0.69 [0.46-0.91], positive predictive value: 0.87 [0.76-0.98] and negative predictive value: 0.24 [0.12-0.36]). CONCLUSIONS: At 3 Tesla, the presence of a parenchymal hyperintense FLAIR signal before thrombolysis is predictive of a poor clinical outcome at 3 months.
Authors: Julia Meisterernst; Pascal P Klinger-Gratz; Lars Leidolt; Matthias F Lang; Gerhard Schroth; Pasquale Mordasini; Mirjam R Heldner; Marie-Luise Mono; Rebekka Kurmann; Monika Buehlmann; Urs Fischer; Marcel Arnold; Jan Gralla; Heinrich P Mattle; Marwan El-Koussy; Simon Jung Journal: PLoS One Date: 2017-09-28 Impact factor: 3.240
Authors: C H Sudre; B Gomez Anson; I Davagnanam; A Schmitt; A F Mendelson; F Prados; L Smith; D Atkinson; A D Hughes; N Chaturvedi; M J Cardoso; F Barkhof; H R Jaeger; S Ourselin Journal: J Neuroradiol Date: 2017-11-11 Impact factor: 3.447