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European Radiology
Published in: European Radiology 12/2022

03-06-2022 | Magnetic Resonance Imaging | Neuro

Prognostic value of post-treatment fluid-attenuated inversion recovery vascular hyperintensity in ischemic stroke after endovascular thrombectomy

Authors: Xiao-Quan Xu, Guang-Chen Shen, Gao Ma, Yue Chu, Shan-Shan Lu, Sheng Liu, Hai-Bin Shi, Fei-Yun Wu

Published in: European Radiology | Issue 12/2022

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Abstract

Objectives

To explore the value of post-treatment fluid-attenuated inversion recovery vascular hyperintensity (FVH) in predicting clinical outcome in patients with acute ischemic stroke (AIS) after endovascular thrombectomy (EVT).

Methods

This retrospective study reviewed data from consecutive patients with large vessel occlusion of anterior circulation between July 2017 and February 2021. Together with other variables, status of post-treatment FVH was assessed for each patient. Good outcome was defined as a 3-month modified Rankin Scale score of 0–2. Chi-square test, Fisher’s exact test, independent-samples t test, multivariate logistic regression analysis, and receiver operating characteristic analysis were used as appropriate.

Results

Among 84 included patients, 48 (57.1%) patients showed post-treatment FVH. Post-treatment FVH significantly correlated with incomplete recanalization (p < 0.05) and low Alberta Stroke Project Early CT Changes Score on post-treatment diffusion-weighted imaging (p < 0.05). Higher incidence of hemorrhage transformation was observed in patients with post-treatment FVH than those without (27.1% vs. 16.7%); however, the difference did not reach significance (p = 0.259). Successful recanalization (odds ratio [OR], 0.024; 95% confidence interval [CI] 0.003–0.194; p < 0.05), lower National Institutes of Health Stroke Scale scores at admission (NIHSSpre) (OR, 1.196; 95% CI, 1.017–1.406; p < 0.05), and no post-treatment FVH (OR, 74.690; 95% CI, 4.624–1206.421; p < 0.05) were found to be independent predictors of good outcomes. Combined models integrating all three independent predictors (recanalization+NIHSSpre+post-treatment FVH) significantly outperformed the combined model without post-treatment FVH (recanalization+NIHSSpre) in predicting clinical outcome (p = 0.004).

Conclusions

Post-treatment FVH may be an effective prognostic marker associated with clinical outcome in patients with AIS after EVT.

Key Points

• Post-treatment FVH correlates with incomplete recanalization and higher infarct volume.
• Post-treatment FVH is independently associated with an unfavorable outcome.
• Post-treatment FVH may provide prognostic information in patients with AIS after EVT.
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Metadata
Title
Prognostic value of post-treatment fluid-attenuated inversion recovery vascular hyperintensity in ischemic stroke after endovascular thrombectomy
Authors
Xiao-Quan Xu
Guang-Chen Shen
Gao Ma
Yue Chu
Shan-Shan Lu
Sheng Liu
Hai-Bin Shi
Fei-Yun Wu
Publication date
03-06-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08886-1

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