Hyperattenuating lesions after mechanical thrombectomy in acute ischaemic stroke: factors predicting symptomatic haemorrhage and clinical outcomes
| Autor: | Hyo Suk Nam, Young Dae Kim, Ji Hoe Heo, Sung Soo Ahn, Byung Moon Kim, Seung Koo Lee, Dongjo Kim, Sung Jin Bae |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Contrast Media Lesion volume 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Ischaemic stroke medicine Humans Radiology Nuclear Medicine and imaging Clinical significance Stroke Aged Ischemic Stroke Retrospective Studies Thrombectomy medicine.diagnostic_test business.industry Magnetic resonance imaging General Medicine medicine.disease Magnetic Resonance Imaging Mechanical thrombectomy Increased risk 030220 oncology & carcinogenesis Baseline characteristics Radiographic Image Interpretation Computer-Assisted Female Radiology business Tomography X-Ray Computed Intracranial Hemorrhages |
| Zdroj: | Clinical radiology. 76(1) |
| ISSN: | 1365-229X |
| Popis: | To evaluate the clinical significance of hyperattenuating lesions on CT after mechanical thrombectomy for acute ischaemic stroke, and to identify imaging factors that predict symptomatic haemorrhage and unfavourable outcomes.Seventy-eight patients with acute ischaemic stroke in the anterior circulation who underwent mechanical thrombectomy were evaluated. All patients underwent post-interventional unenhanced computed tomography (CT) within 24 h and follow-up CT or magnetic resonance imaging (MRI) within 7 days. Baseline characteristics and clinical outcomes were compared between patients with and without hyperattenuating lesions. In patients with hyperattenuating lesions, clinical and imaging factors that predict symptomatic haemorrhage and unfavourable outcomes were determined.Fifty-six of 78 patients (71.8%) demonstrated hyperattenuating lesions on post-interventional CT. Patients with hyperattenuating lesions showed lower Alberta Stroke Program Early CT score (ASPECTS), persistent/symptomatic haemorrhage, and unfavourable outcomes than those without. In patients with hyperattenuating lesions, larger hyperattenuating lesion volume (21.3 ml; OR, 55.60, p0.001) and perilesional oedema (OR, 46.04, p=0.015) were independent factors predicting symptomatic haemorrhage. Older age (OR, 1.2, p=0.006) and lower ASPECTS (OR, 0.45, p=0.046) were independent factors predicting unfavourable outcomes in patients with hyperattenuating lesions. Adding the volume of the hyperattenuating lesion to age and ASPECTS increased the predictive performance of unfavourable outcomes (area under the curve 0.874 versus 0.934, p=0.043).Hyperattenuating lesions on post-interventional CT are associated with increased risk of symptomatic haemorrhage and unfavourable outcomes. Larger hyperattenuating lesion volume is an independent factor of symptomatic haemorrhage and it has added predictive value for unfavourable outcomes. |
| Databáze: | OpenAIRE |
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