Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, China.
Department of Intervention, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Brain Imaging Behav. 2020 Aug;14(4):1230-1237. doi: 10.1007/s11682-019-00156-x.
The value of fluid-attenuated inversion recovery vascular hyperintensity (FVH)-diffusion-weighted imaging (DWI)mismatch in predicting outcome with acute stroke is unclear. We assessed the association between FVH-DWI mismatch and functional outcome in patients with acute stroke patients receiving endovascular therapy. FVH-DWI mismatch, DWI volume, the functional outcome at 3 months (modified Rankin scale; mRS) and other clinical data were collected for 59 acute stroke patients receiving MRI within 6 h before endovascular therapy. Statistical analysis was performed to predict functional outcome after stroke. Patients with FVH-DWI mismatch (n = 39) had a higher FVH score (p = 0.038), smaller DWI volume (p = 0.007), higher American Society of Interventional and Therapeutic Neuroradiology (ASITN) (p = 0.043), higher interval time of ASITN (p = 0.038), and better functional outcome (p = 0.010) than patients with no FVH-DWI mismatch (n = 20). The good functional outcome group (n = 32) had a higher FVH score (p = 0.028), smaller DWI volume (p = 0.003) and higher ASITN grade (p = 0.043) than the poor functional outcome group (n = 27). Multivariable logistic analysis demonstrated that DWI volume (OR, 1.031; 95% CI, 1.005-1.058; P = 0.021) and FVH-DWI mismatch (OR, 14.311; 95% CI, 2.670-76.703; P = 0.002) were independently associated with functional outcome. Assessing DWI volume and FVH-DWI mismatch in acute stroke patients might be useful for predicting functional outcome after stroke.
FLAIR 血管高信号（FVH）-弥散加权成像（DWI）不匹配对急性脑卒中患者预后的预测价值尚不清楚。我们评估了接受血管内治疗的急性脑卒中患者 FVH-DWI 不匹配与功能结局之间的相关性。收集了 59 例接受血管内治疗前 6 小时内 MRI 的急性脑卒中患者的 FVH-DWI 不匹配、DWI 体积、3 个月时的功能结局（改良 Rankin 量表；mRS）和其他临床数据。进行了统计学分析以预测卒中后的功能结局。FVH-DWI 不匹配的患者（n=39）FVH 评分较高（p=0.038），DWI 体积较小（p=0.007），美国介入和治疗神经放射学会（ASITN）评分较高（p=0.043），ASITN 间隔时间较长（p=0.038），功能结局较好（p=0.010），而无 FVH-DWI 不匹配的患者（n=20）则不然。功能结局良好组（n=32）FVH 评分较高（p=0.028），DWI 体积较小（p=0.003），ASITN 分级较高（p=0.043），功能结局较差组（n=27）则不然。多变量逻辑分析表明，DWI 体积（OR，1.031；95%CI，1.005-1.058；P=0.021）和 FVH-DWI 不匹配（OR，14.311；95%CI，2.670-76.703；P=0.002）与功能结局独立相关。评估急性脑卒中患者的 DWI 体积和 FVH-DWI 不匹配可能有助于预测卒中后的功能结局。
