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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.

[1]
Pandian JD, Gall SL, Kate MP, et al. Prevention of stroke: a global perspective. Lancet, 2018, 392(10154): 1269-1278. DOI: 10.1016/S0140-6736(18)31269-8
[2]
美国神经介入外科学会（发布）, Yasha K, Philip MM，等．后循环大血管闭塞性卒中的血管内治疗策略：美国神经介入外科学会(SNIS)标准和指南委员会共识．中华介入放射学电子杂志, 2019, 7(4): 263-272.
[3]
Adams HP Jr, Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in acute stroke treatment. Stroke, 1993, 24(1): 35-41. DOI: 10.1161/01.str.24.1.35
[4]
Jiang L, Chen YC, Zhang H, et al. FLAIR vascular hyperintensity in acute stroke is associated with collateralization and functional outcome. Eur Radiol, 2019, 29(9): 4879-4888. DOI: 10.1007/s00330-019-06022-0
[5]
Li Y, Cai Y, Zhao M, et al. Risk factors between intracranial-extracranial atherosclerosis and anterior-posterior circulation stroke in ischemic stroke. Neurological research, 2017, 39(1): 30-35. DOI: 10.1080/01616412.2016.1250856
[6]
中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018.中华神经科杂志, 2018, 51(9): 666-682. DOI: cma.J.issn.1006-7876.2018.09.004
[7]
Kim JS, Nah HW, Pare SM, et al. Risk factors and stroke mechanisms in atherosclerotic stroke: intracranial compared with extracranial and anterior compared with posterior circulation disease. Stroke, 2012, 43(12): 3313-3318. DOI: 10.1161/STROKEAHA.112.658500
[8]
Almekhlafi MA, Mishra S, Desai JA, et al. Not all "successful" angiographic reperfusion patients are an equal validation of a modified TICI scoring system. Int Neuroradiol, 2014, 20(1): 21-27. DOI: 10.15274/INR-2014-10004
[9]
杜娟，崔永强，吴铮，等．急性缺血性卒中动脉内机械取栓困难的临床分析．中华外科杂志, 2016, 54(5): 335-339. DOI: 10.3760/cma.j.issn.0529-8515.2016.05004
[10]
Nordmeyer H, Webering N, Chapot R, et al. The association between collateral status, recanalization and long term outcome in stroke patients treated with stent retrievers: are there indications not to perform thrombectomy based on CT angiography? J Neuroradiol, 2017, 44(3): 217-222. DOI: 10.1016/j.neurad.2016.12.009
[11]
Leng X, Fang H, Leung TW, et al. Impact of collateral status on successful revascularization in endovascular treatment: a systematic review and meta-analysis. Cerebrovascular dis, 2016, 41(1-2): 27-34. DOI: 10.1159/000441803
[12]
Mitsumura H, Miyagawa S, Komatsu T, et al. Relationship between vertebral artery hypoplasia and posterior circulation ischemia. J Stroke Cerebrovascu Dis, 2016, 25(2): 266-269. DOI: 10.1016/j.jstrokecerebrovasdis.2015.09.027
[13]
Zeumer H, Hacke W, Kolmann HL, et al. Local fibrinolysis in basilar artery thrombosis (author's transl). Deutsch Med Wochenschr, 1982, 107(19): 728-731. DOI: 10.1055/s-2008-1070010
[14]
Hacke W, Zeumer H, Ferbert A, et al. Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke, 1988, 19(10): 1216-1222. DOI: 10.1161/01.str.19.10.1216
[15]
Voetsch B, DeWitt LD, Pessin MS, et al. Basilar artery occlusive disease in the New England Medical Center Posterior Circulation Registry. Archiv Neurol, 2004, 61(4): 496-504. DOI: 10.1001/archneur.61.4.496
[16]
Raoult H, Lassalle MV, Parat B, et al. DWI-based algorithm to predict disability in patients treated with thrombectomy for acute stroke. AJNR Am J Neuroradiol, 2020, 41(2): 274-279. DOI: 10.3174/ajnr.A6379
[17]
Lansberg MG, Straka M, Kemp S, et al. MRI profile and response to endovascular reperfusion after stroke (DEFUSE 2): a prospective cohort study. Lancet Neurol, 2012, 11(10): 860-867. DOI: 10.1016/S1474-4422(12)70203-X
[18]
Ribo M, Tomasello A, Lemus M, et al. Maximal admission core lesion compatible with favorable outcome in acute stroke patients undergoing endovascular procedures. Stroke, 2015, 46(10): 2849-2852. DOI: 10.1161/STROKEAHA.115.010707
[19]
Sanak D, Nosal V, Horak D, et al. Impact of diffusion-weighted MRI-measured initial cerebral infarction volume on clinical outcome in acute stroke patients with middle cerebral artery occlusion treated by thrombolysis. Neuroradiology, 2006, 48(9): 632-639. DOI: 10.1007/s00234-006-0105-0

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