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• Clinical Article •
The study of functional outcome difference and risk factors between intracranial anterior and posterior circulation in acute stroke patients
WU Han  LI Lu  JIN Mingxu  PENG Mingyang  YIN Xindao  WANG Tongxing 

Cite this article as: Wu H, Li L, Jin MX, et al. The study of functional outcome difference and risk factors between intracranial anterior and posterior circulation in acute stroke patients. Chin J Magn Reson Imaging, 2020, 11(11): 985-989. DOI:10.12015/issn.1674-8034.2020.11.006.


[Abstract] Objective: To explore the functional outcome difference and risk factors between intracranial anterior and posterior circulation in acute stroke patients.Materials and Methods: Two hundred and ten acute anterior stroke patients and 85 acute posterior stroke patients in our hospital were retrospectively enrolled. All patients≤24 hours of symptom onset and underwent MRI examination before therapy. Patients were divided into intravenous thrombolysis group and arterial thrombectomy group. The clinical data, diffusion-weighted imaging (DWI) infarct volume, vascular recanalization (mTICI score) and the functional outcome at 3 months (mRS) were collected. Statistical analysis was performed to compare the functional outcome difference and risk factors between intracranial anterior and posterior circulation in acute stroke patients.Results: Of the 200 patients underwent intravenous thrombolysis, DWI infarct volume in the anterior circulation group (n=150) was significantly larger than that in posterior circulation group (n=50) (28.04±21.72 vs 13.54±15.17; t=-4.077, P=0.023); while the proportion of good functional outcome in the anterior circulation group was significantly higher than that in posterior circulation group (72.67% vs 42.00%; χ2=15.502, P=0.000). Of the 95 patients underwent arterial thrombectomy, DWI infarct volume in the anterior circulation group (n=50) was significantly larger than that in posterior circulation group (n=35) (68.04±17.39 vs 43.54±6.17; t=-2.170, P=0.037), the vascular recanalization rate was significantly higher than that in posterior circulation group (mTICI score 2b-3: 78.33% vs 51.43%; χ2=7.406, P=0.011). Compared with the posterior circulation group, the functional outcome in the anterior circulation group was better (70.00% vs 45.71%); χ2=5.483; P=0.029). Logistic regression analysis showed that DWI infarct volume [OR (95% CI): 1.34 (1.17—1.54); P=0.021] was independent predictor factors of functional outcome in acute stroke patients underwent intravenous thrombolysis. DWI infarct volume [OR (95% CI): 1.19 (1.07—2.85); P=0.034], mTICI score [OR (95% CI): 3.88 (1.27—11.78); P=0.016] were independent predictor factors of functional outcome in acute stroke patients underwent arterial thrombectomy.Conclusions: The functional outcome of acute anterior stroke patients is better than that of acute posterior stroke patients. Evaluating DWI volume and vascular recanalization comprehensively may be useful in predicting the functional outcome of acute stroke patients.
[Keywords] stroke；magnetic resonance imaging；anterior circulation；posterior circulation；prognosis

WU Han Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

LI Lu Department of Radiology, China-Japan friendship hospital, Beijing 100029, China

JIN Mingxu Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

PENG Mingyang Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

YIN Xindao Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

WANG Tongxing* Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

*Correspondence to: Wang TX, E-mail: txking@126.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This article is supported by the Jiangsu Science and Technology Development Project No. BE2017614
Received  2020-05-13
Accepted  2020-09-20
DOI: 10.12015/issn.1674-8034.2020.11.006
Cite this article as: Wu H, Li L, Jin MX, et al. The study of functional outcome difference and risk factors between intracranial anterior and posterior circulation in acute stroke patients. Chin J Magn Reson Imaging, 2020, 11(11): 985-989. DOI:10.12015/issn.1674-8034.2020.11.006.

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