Fluid-Attenuated Inversion Recovery Vascular Hyperintensity Topography, Novel Imaging Marker for Revascularization in Middle Cerebral Artery Occlusion
| Autor: | Xinfeng Liu, Latisha K Ali, Doojin Kim, Jason D Hinman, Qiliang Dai, Fabien Scalzo, Wen Sun, David S Liebeskind, Dezhi Liu, Neal M Rao, Jeffrey L. Saver |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Middle Cerebral Artery Aging Outcome Assessment middle cerebral artery occlusion medicine.medical_treatment Cardiorespiratory Medicine and Haematology Fluid-attenuated inversion recovery Severity of Illness Index 030218 nuclear medicine & medical imaging 0302 clinical medicine Modified Rankin Scale Interquartile range Outcome Assessment Health Care 80 and over magnetic resonance imaging Thrombolytic Therapy Stroke Aged 80 and over screening and diagnosis medicine.diagnostic_test Infarction Middle Cerebral Artery Middle Aged stroke Magnetic Resonance Imaging Detection Infarction thrombectomy Cerebrovascular Circulation Biomedical Imaging Female Radiology medicine.symptom Cardiology and Cardiovascular Medicine 4.2 Evaluation of markers and technologies Adult medicine.medical_specialty hypertension Mechanical Thrombolysis Clinical Sciences Revascularization Article Lesion 03 medical and health sciences Clinical Research medicine Humans Aged Advanced and Specialized Nursing Neurology & Neurosurgery business.industry Neurosciences Magnetic resonance imaging medicine.disease Hyperintensity Brain Disorders Cerebral Angiography Health Care Neurology (clinical) business Biomarkers 030217 neurology & neurosurgery |
| Zdroj: | Stroke, vol 47, iss 11 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/strokeaha.116.013953 |
| Popis: | Background and Purpose— In acute arterial occlusion, fluid-attenuated inversion recovery vascular hyperintensity (FVH) has been linked to slow flow in leptomeningeal collaterals and cerebral hypoperfusion, but the impact on clinical outcome is still controversial. In this study, we aimed to investigate the association between FVH topography or FVH-Alberta Stroke Program Early CT Score (ASPECTS) pattern and outcome in acute M1-middle cerebral artery occlusion patients with endovascular treatment. Methods— We included acute M1-middle cerebral artery occlusion patients treated with endovascular therapy (ET). All patients had diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery before ET. Distal FVH-ASPECTS was evaluated according to distal middle cerebral artery-ASPECT area (M1–M6) and acute DWI lesion was also reviewed. The presence of FVH inside and outside DWI-positive lesions was separately analyzed. Clinical outcome after ET was analyzed with respect to different distal FVH-ASPECTS topography. Results— Among 101 patients who met inclusion criteria for the study, mean age was 66.2±17.8 years and median National Institutes of Health Stroke Scale was 17.0 (interquartile range, 12.0–21.0). FVH-ASPECTS measured outside of the DWI lesion was significantly higher in patients with good outcome (modified Rankin Scale [mRS] score of 0–2; 8.0 versus 4.0, P P =0.013). FVH-ASPECTS inside the DWI lesion was associated with hemorrhagic transformation (odds ratio, 1.3; 95% confidence interval, 1.04–1.51; P =0.019). Conclusions— Higher FVH-ASPECTS measured outside the DWI lesion is associated with good clinical outcomes in patients undergoing ET. FVH-ASPECTS measured inside the DWI lesion was predictive of hemorrhagic transformation. The FVH pattern, not number, can serve as an imaging selection marker for ET in acute middle cerebral artery occlusion. |
| Databáze: | OpenAIRE |
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