Tao Yuan1, Guoli Ren2, Xianning Hu1, Lina Geng1, Xueqing Li3, Shuang Xia4, Guanmin Quan5. 1. Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China. 2. Department of Medical Imaging, Liaocheng People's Hospital, Liaocheng, China. 3. Department of Medical Imaging, Lingshou County People's Hospital, Shijiazhuang, China. 4. Department of Radiology, Tianjin First Central Hospital, Tianjin, China. 5. Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China. quanguanmin@163.com.
Abstract
BACKGROUND AND AIMS: Whether fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH)-DWI mismatch could predict the outcome or not remains in debate. The aim of this study was to identify if FVH combined with the other markers improved favorable outcome prediction of acute infarctions in patients with unilateral acute internal carotid artery (ICA) occlusion. METHODS: Consecutive 68 adult acute middle cerebral artery (MCA) territory infarction patients caused by acute ICA occlusion, including favorable (n = 38, mRS ≤ 2) and unfavorable (n = 30, mRS > 2) groups, were enrolled in this retrospective analysis. The diagnostic efficiency of favorable clinical outcome of FVH-DWI mismatch was compared with those of DWI lesions volumetry and the combined marker of FVH-DWI mismatch and other factors. RESULTS: There were more prominent FVH-DWI mismatch (≥ 3 sections) (84%), less atrial fibrillation (AFib) (13%), and more tandem MCA normal or mild stenosis (63%) in favorable outcome group than those (30%, 40%, and 27%, respectively) in unfavorable group. Univariate and multivariate analyses showed that the prominent FVH-DWI mismatch was the positive predictive factor for favorable outcome (OR = 2.643 and 3.200). Prominent FVH-DWI mismatch, in combination with tandem MCA normal or mild stenosis, and absence of Afib, had better performance (AUC = 0.875) than that of initial DWI lesion volumetry (AUC = 0.854) and any other single factor (AUC = 0.634~0.820) in predicting favorable outcome. CONCLUSIONS: Prominent FVH-DWI mismatch was associated with favorable outcome in acute infarctions in unilateral ICA occlusion patients. Its predictive performance would be improved when combined with the assessment of tandem lesions of MCA and AFib.
BACKGROUND AND AIMS: Whether fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH)-DWI mismatch could predict the outcome or not remains in debate. The aim of this study was to identify if FVH combined with the other markers improved favorable outcome prediction of acute infarctions in patients with unilateral acute internal carotid artery (ICA) occlusion. METHODS: Consecutive 68 adult acute middle cerebral artery (MCA) territory infarctionpatients caused by acute ICA occlusion, including favorable (n = 38, mRS ≤ 2) and unfavorable (n = 30, mRS > 2) groups, were enrolled in this retrospective analysis. The diagnostic efficiency of favorable clinical outcome of FVH-DWI mismatch was compared with those of DWI lesions volumetry and the combined marker of FVH-DWI mismatch and other factors. RESULTS: There were more prominent FVH-DWI mismatch (≥ 3 sections) (84%), less atrial fibrillation (AFib) (13%), and more tandem MCA normal or mild stenosis (63%) in favorable outcome group than those (30%, 40%, and 27%, respectively) in unfavorable group. Univariate and multivariate analyses showed that the prominent FVH-DWI mismatch was the positive predictive factor for favorable outcome (OR = 2.643 and 3.200). Prominent FVH-DWI mismatch, in combination with tandem MCA normal or mild stenosis, and absence of Afib, had better performance (AUC = 0.875) than that of initial DWI lesion volumetry (AUC = 0.854) and any other single factor (AUC = 0.634~0.820) in predicting favorable outcome. CONCLUSIONS: Prominent FVH-DWI mismatch was associated with favorable outcome in acute infarctions in unilateral ICA occlusionpatients. Its predictive performance would be improved when combined with the assessment of tandem lesions of MCA and AFib.
Authors: Sibu Mundiyanapurath; Peter A Ringleb; Sascha Diatschuk; Sina Burth; Markus Möhlenbruch; Ralf O Floca; Wolfgang Wick; Martin Bendszus; Alexander Radbruch Journal: Eur J Radiol Date: 2015-12-29 Impact factor: 3.528
Authors: Marjolein de Weerd; Jacoba P Greving; Bo Hedblad; Matthias W Lorenz; Ellisiv B Mathiesen; Daniel H O'Leary; Maria Rosvall; Matthias Sitzer; Erik Buskens; Michiel L Bots Journal: Stroke Date: 2010-04-29 Impact factor: 7.914
Authors: M Hohenhaus; W U Schmidt; P Brunecker; C Xu; B Hotter; M Rozanski; J B Fiebach; G J Jungehülsing Journal: Cerebrovasc Dis Date: 2012-06-28 Impact factor: 2.762
Authors: Sibu Mundiyanapurath; Peter Arthur Ringleb; Sascha Diatschuk; Mikkel Bo Hansen; Kim Mouridsen; Leif Østergaard; Wolfgang Wick; Martin Bendszus; Alexander Radbruch Journal: PLoS One Date: 2016-06-23 Impact factor: 3.240