Can Early Ischemic Lesion Recurrence on Diffusion-Weighted MRI Affect Functional Outcome after Acute Ischemic Stroke?.
- Author:
Wook Joo KIM
1
;
Jae Hyoung KIM
;
Youngchai KO
;
Jung Hyun PARK
;
Mi Hwa YANG
;
Myung Suk JANG
;
Moon Ku HAN
;
Sang Yun KIM
;
Seong Ho PARK
;
Hee Joon BAE
Author Information
- Publication Type:Original Article
- Keywords: diffusion MRI; cerebral infarction; recurrence; modified Rankin Disability Scale
- MeSH: Cerebral Infarction; Diffusion Magnetic Resonance Imaging; Electrolytes; Follow-Up Studies; Humans; Odds Ratio; Prospective Studies; Recurrence; Stroke
- From:Journal of Clinical Neurology 2010;6(1):19-26
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND PURPOSE: Ischemic lesion recurrence on diffusion-weighted imaging (DWI-LR) is a frequently observed phenomenon after acute ischemic stroke. However, no study has elucidated the impact of DWI-LR on functional outcome. METHODS: Among a consecutive series of patients who presented with focal symptoms or signs compatible with stroke within 48 hours from the onset over a 50-month period, those who had relevant ischemic lesions on initial DWI and underwent follow-up DWI within 14 days after the onset were enrolled in this study. As outcome variables, the scores on the modified Rankin Disability Scale (mRDS) at 3 months and 1 year were measured prospectively and dichotomized into good (0-2) vs. poor (3-6). When calculating odds ratios (ORs), adjustment was performed for age, previous stroke, initial score on the NIH Stroke Scale, stroke subtype, and IV thrombolysis. RESULTS: Among those 786 patients finally enrolled in this study, 221 (28.1%) had DWI-LR. For a poor outcome at 3 months, the crude ORs of any, symptomatic, and asymptomatic DWI-LR were 2.70 [95% confidence interval (CI), 1.96 to 3.72], 10.03 (95% CI, 4.39 to 22.96), and 2.04 (95% CI, 1.44 to 2.88), respectively. With adjustment, the OR of symptomatic DWI-LR was 6.44 (95% CI, 2.50 to 16.57), whereas those of any and asymptomatic DWI-LR lost their statistical significance: 1.44 (95% CI, 0.94 to 2.20) and 1.04 (95% CI, 0.65 to 1.65), respectively. Analyzing with the 1-year outcome produced similar results. CONCLUSIONS: This study shows that symptomatic early lesion recurrence can affect functional outcome after acute ischemic stroke, whereas an asymptomatic one may not.
