Relative diffusion-weighted imaging signal intensity predicts outcome in cardioembolic stroke patients with successful recanalization after endovascular treatment
10.3760/cma.j.issn.1673-4165.2024.05.001
- VernacularTitle:弥散加权成像相对信号强度预测血管内治疗后血管成功再通的心源性栓塞性卒中患者的转归
- Author:
Feng HE
1
;
Yingge WANG
;
Haoming ZHANG
;
Zhensheng LIU
;
Zhen LIU
;
Tieyu TANG
Author Information
1. 扬州大学附属医院神经内科，扬州 225001
- Keywords:
Ischemic stroke;
Embolic stroke;
Diffusion magnetic resonance imaging;
Endovascular procedures;
Thrombectomy;
Reperfusion;
Treatment outcome
- From:
International Journal of Cerebrovascular Diseases
2024;32(5):321-325
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive role of relative diffusion-weighted imaging (DWI) signal intensity (DWI-rSI) in outcome in patients with anterior circulation large vessel occlusion cardioembolic stroke and successful recanalization after endovascular therapy (EVT).Methods:Patients with anterior circulation large vessel occlusion stroke due to cardioembolic embolism underwent EVT and successful recanalization at the Affiliated Hospital of Yangzhou University from March 2017 to March 2023 were retrospectively included. According to the modified Rankin Scale score 3 months after procedure, the patients were divided into a good outcome group (0-2 points) and a poor outcome group (3-6 points). Multivariate logistic regression analysis was used to identify independent predictive factors for poor outcome. Results:A total of 59 patients were enrolled, including 29 males (49.2%), median age of 74 years (interquartile range, 68-80 years). The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 15 (12-21), and the median DWI Alberta Stroke Program Early CT Score (ASPECTS) was 8 (5-9). Thirty-two patients (54.2%) had good outcome, and 27 (45.8%) had poor outcome. Among them, 9 patients (15.3%) died (6 died from cerebral herniation after malignant brain edema, 2 died from complications, and 1 died from severe intracranial hemorrhage after procedure). Twenty-one patients (35.6%) experienced hemorrhagic transformation, including 12 (20.3%) with symptomatic intracranial hemorrhage. There were significant differences in baseline systolic blood pressure, NIHSS score, DWI-ASPECTS, DWI-rSI, and incidence of symptomatic intracranial hemorrhage between the good outcome group and the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that baseline systolic blood pressure (odds ratio 0.977, 95% confidence interval 0.919-0.991; P=0.015) and DWI-rSI (odds ratio 11.809, 95% confidence interval 1.932-72.170; P=0.008) were the independent predictors for poor outcome. Conclusion:DWI-rSI can predict the outcome of patients with anterior circulation large vessel occlusion cardioembolic stroke and successful recanalization after EVT.
