Share：
Share this content in WeChat
X
[Chinese][PDF]1088102
• Clinical Article •
The study of ischemic core volume combined with the relative perfusion ratio in evaluating vascular recanalization and prognosis in acute stroke
LI Dong  PENG Mingyang  WANG Tongxing  CHEN Guozhong  Yin Xindao  WU Gang 

Cite this article as: Li D, Peng MY, Wang TX, et al. The study of ischemic core volume combined with the relative perfusion ratio in evaluating vascular recanalization and prognosis in acute stroke[J]. Chin J Magn Reson Imaging, 2022, 13(2): 1-5. DOI:10.12015/issn.1674-8034.2022.02.001.


[Abstract] Objective To investigate the value of ischemic core volume (ICV) combined with the relative perfusion ratio before endovascular thrombectomy (EVT) in evaluating vascular recanalization and outcome in acute stroke.Materials and Methods A total of 200 acute ischemic stroke patients in our hospital were analyzed retrospectively. All patients underwent MRI examination before therapy within 24 h. Perfusion weighting ICV (pw-ICV) was defined as ICV multiply by relative cerebral blood flow (rCBF). Complete recanalization was assessed by mTICI grading (0-2a: incomplete recanalization; 2b-3: complete recanalization); the outcome was evaluated by using mRS score at 3 months (0-2 score: good outcome; 3-6 score: poor outcome). Statistical analysis was performed to evaluate the value of pw-ICV in predicting vascular recanalization and outcome.Results Compared with incomplete revascularization group (n=68), the complete revascularization group had a smaller ICV before therapy was (27.31±19.18 vs. 54.45±29.87) and smaller pw-ICV (103.82±77.46 vs. 216.20±88.19), the difference was statistically significant (P＜0.05). Compared with the outcome group (n=129), the good outcome group (n=71) had a lower NIHSS score (15.71±6.18 vs. 18.27±6.37), smaller ICV before therapy (28.42±17.38 vs. 53.51±28.79) and smaller pw-ICV (113.27±79.61 vs. 221.07±87.37) and higher recanalization rate (89.15% vs. 23.94%), the difference was statistically significant (P＜0.05). Logistic multiple logistic regression analysis showed that pw-ICV (OR 0.930; 95% CI: 0.854-1.465; P=0.016) was an independent predictor of recanalization in acute stroke; pw-ICV (OR 0.971; 95% CI: 0.551-1.865; P=0.025) and complete recanalization (OR 5.26; 95% CI: 1.572-13.179; P=0.037) were independent predictor of the outcome in acute stroke.Conclusions pw-ICV plays an important role in recanalization and outcome of acute ischemic stroke before EVT therapy.
[Keywords] stroke；magnetic resonance imaging；perfusion imaging；ischemic core volume；vascular recanalization；prognosis

LI Dong1   PENG Mingyang2   WANG Tongxing2   CHEN Guozhong2   Yin Xindao2   WU Gang2*  

1 Department of Medical Imaging, Jiangyin Hospital of Traditional Chinese Medicine, Wuxi 214400, China

2 Department of Medical Imaging, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

Wu G, E-mail: doc__wu@139.com

Conflicts of interest   None.

ACKNOWLEDGMENTS National Natural Science Foundation of China (No. 82001811); Natural Science Foundation of Jiangsu Province (No. BK20201118).
Received  2021-07-02
Accepted  2021-12-28
DOI: 10.12015/issn.1674-8034.2022.02.001
Cite this article as: Li D, Peng MY, Wang TX, et al. The study of ischemic core volume combined with the relative perfusion ratio in evaluating vascular recanalization and prognosis in acute stroke[J]. Chin J Magn Reson Imaging, 2022, 13(2): 1-5. DOI:10.12015/issn.1674-8034.2022.02.001.

[1]
Hasan TF, Todnem N, Gopal N, et al. Endovascular Thrombectomy for Acute Ischemic Stroke[J]. Current cardiology reports, 2019, 21(10): 112. DOI: 10.1007/s11886-019-1217-6.
[2]
Wang A, Abramowicz AE. Endovascular thrombectomy in acute ischemic stroke: new treatment guide[J]. Current opinion in anaesthesiology, 2018, 31(4): 473-480. DOI: 10.1097/ACO.0000000000000621.
[3]
Albers GW, Goyal M, Jahan R, et al. Ischemic core and hypoperfusion volumes predict infarct size in SWIFT PRIME[J]. Ann Neurol, 2016, 79(1): 76-89. DOI: 10.1002/ana.24543.
[4]
Shiraz Bhurwani MM, Snyder KV, Waqas M, et al. Use of quantitative angiographic methods with a data-driven model to evaluate reperfusion status (mTICI) during thrombectomy[J]. Neuroradiology, 2021, 63(9): 1429-1439. DOI: 10.1007/s00234-020-02598-3.
[5]
Ko CC, Liu HM, Chen TY, et al. Prediction of mTICI 3 recanalization and clinical outcomes in endovascular thrombectomy for acute ischemic stroke: a retrospective study in the Taiwan registry[J]. Neurol Sci, 2021, 42(6): 2325-2335. DOI: 10.1007/s10072-020-04800-z.
[6]
National Health Commission Stroke Prevention Expert Commission Neuroimaging Committee, Chinese Medical Association Radiology Society Neuroimaging Group. Chinese guideline for standard utilization of imaging for cerebrovascular diseases[J]. Chin J Radiol, 2019, 53(11): 916-940. DOI: 10.3760/cma.j.issn.1005-1201.2019.11.002.
[7]
Albers GW, Lansberg MG, Kemp S, et al. A multicenter randomized controlled trial of endovascular therapy following imaging evaluation for ischemic stroke (DEFUSE 3)[J]. Int J Stroke, 2017, 12(8): 896-905. DOI: 10.1177/1747493017701147.
[8]
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[J]. Chin J Magn Reson Imaging, 2020, 11(11): 985-989. DOI: 10.12015/issn.1674-8034.2020.11.006.
[9]
Raoult H, Lassalle MV, Parat B, et al. Dwi-based algorithm to predict disability in patients treated with thrombectomy for acute stroke[J]. AJNR, 2020, 41(2): 274-279. DOI: 10.3174/ajnr.A6379.
[10]
Wouters A, Nysten C, Thijs V, et al. Prediction of Outcome in Patients With Acute Ischemic Stroke Based on Initial Severity and Improvement in the First 24 h[J]. Front Neurol, 2018, 9: 308. DOI: 10.3389/fneur.2018.00308.
[11]
Wang W, Zhao J, Peng MY, et al. To explore the outcome differences in acute ischemic stroke with different time windows after mechanical thrombectomy[J]. Chin J Magn Reson Imaging, 2021, 12(3): 39-43. DOI: 10.12015/issn.1674-8034.2021.03.009.
[12]
Olivot JM, Mosimann PJ, Labreuche J, et al. Impact of diffusion-weighted imaging lesion volume on the success of endovascular reperfusion therapy[J]. Stroke, 2013, 44(8): 2205-2211. DOI: 10.1161/STROKEAHA.113.000911.
[13]
Huang HT, Qiu JB, Chen GH, et al. Influencing factors of vascular recanalization after endovascular thrombectomy for acute stroke[J]. Journal of Clinical Neurology, 2020, 33(5): 367-370. DOI: 10.3969/j.issn.1004-1648.2020.05.012.
[14]
Kim JS, Cha JK, Nah HW, et al. The Processing Time for Recanalization and Size of Ischemic Lesions on DWI is Related With Complete Reperfusion After Mechanical Thrombectomy[J]. J Stroke Cerebrovasc Dis, 2018, 27(11): 3266-3271. DOI: 10.1016/j.jstrokecerebrovasdis.2018.07.025.
[15]
Nogueira RG, Jadhav AP, Haussen DC, et al. Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct[J]. N Engl J Med, 2018, 378(1): 11-21. DOI: 10.1056/NEJMoa1706442.
[16]
Albers GW, Goyal M, Jahan R, et al. Ischemic core and hypoperfusion volumes predict infarct size in SWIFT PRIME[J]. Ann Neurol, 2016, 79(1): 76-89. DOI: 10.1002/ana.24543.
[17]
Zhou SB, Zhang XM, Gao Y, et al. Diffusion-weighted imaging volume and diffusion-weighted imaging volume growth in acute stroke: associations with fluid-attenuated inversion recovery hyperintensities-diffusion-weighted imaging mismatch and functional outcome[J]. Neuroreport, 2019, 30(13): 875-881. DOI: 10.1097/WNR.0000000000001291.
[18]
Raoult H, Lassalle MV, Parat B, et al. Dwi-based algorithm to predict disability in patients treated with thrombectomy for acute stroke[J]. AJNR, 2020, 41(2): 274-279. DOI: 10.3174/ajnr.A6379.
[19]
Mokin M, Levy EI, Saver JL, et al. Predictive Value of RAPID Assessed Perfusion Thresholds on Final Infarct Volume in SWIFT PRIME (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment)[J]. Stroke, 2017, 48(4): 932-938. DOI: 10.1161/STROKEAHA.116.015472.
[20]
Rotkopf LT, Tiedt S, Puhr-Westerheide D, et al. Ischemic Core Volume Combined with the Relative Perfusion Ratio for Stroke Outcome Prediction after Endovascular Thrombectomy[J]. J Neuroimaging, 2020, 30(3): 321-326. DOI: 10.1111/jon.12695.

PREV Principle and clinical application of high resolution magnetic resonance diffusion imaging with multiplexed sensitivity encoding
NEXT Preoperatively predict pathological grading of meningiomas using radiomics model based on transverse and sagittal enhanced T1WI images: a preliminary study
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn