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Erschienen in: Neurological Sciences 12/2019

07.08.2019 | Original Article

Added assessment of middle cerebral artery and atrial fibrillation to FLAIR vascular hyperintensity-DWI mismatch would improve the outcome prediction of acute infarction in patients with acute internal carotid artery occlusion

verfasst von: Tao Yuan, Guoli Ren, Xianning Hu, Lina Geng, Xueqing Li, Shuang Xia, Guanmin Quan

Erschienen in: Neurological Sciences | Ausgabe 12/2019

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Abstract

Background and aims

Whether fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH)-DWI mismatch could predict the outcome or not remains in debate. The aim of this study was to identify if FVH combined with the other markers improved favorable outcome prediction of acute infarctions in patients with unilateral acute internal carotid artery (ICA) occlusion.

Methods

Consecutive 68 adult acute middle cerebral artery (MCA) territory infarction patients caused by acute ICA occlusion, including favorable (n = 38, mRS ≤ 2) and unfavorable (n = 30, mRS > 2) groups, were enrolled in this retrospective analysis. The diagnostic efficiency of favorable clinical outcome of FVH-DWI mismatch was compared with those of DWI lesions volumetry and the combined marker of FVH-DWI mismatch and other factors.

Results

There were more prominent FVH-DWI mismatch (≥ 3 sections) (84%), less atrial fibrillation (AFib) (13%), and more tandem MCA normal or mild stenosis (63%) in favorable outcome group than those (30%, 40%, and 27%, respectively) in unfavorable group. Univariate and multivariate analyses showed that the prominent FVH-DWI mismatch was the positive predictive factor for favorable outcome (OR = 2.643 and 3.200). Prominent FVH-DWI mismatch, in combination with tandem MCA normal or mild stenosis, and absence of Afib, had better performance (AUC = 0.875) than that of initial DWI lesion volumetry (AUC = 0.854) and any other single factor (AUC = 0.634~0.820) in predicting favorable outcome.

Conclusions

Prominent FVH-DWI mismatch was associated with favorable outcome in acute infarctions in unilateral ICA occlusion patients. Its predictive performance would be improved when combined with the assessment of tandem lesions of MCA and AFib.
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Metadaten
Titel
Added assessment of middle cerebral artery and atrial fibrillation to FLAIR vascular hyperintensity-DWI mismatch would improve the outcome prediction of acute infarction in patients with acute internal carotid artery occlusion
verfasst von
Tao Yuan
Guoli Ren
Xianning Hu
Lina Geng
Xueqing Li
Shuang Xia
Guanmin Quan
Publikationsdatum
07.08.2019
Verlag
Springer International Publishing
Erschienen in
Neurological Sciences / Ausgabe 12/2019
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-019-04029-5

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