Xie Yu, Oster Julien, Micard Emilien, Chen Bailiang, Douros Ioannis K, Liao Liang, Zhu François, Soudant Marc, Felblinger Jacques, Guillemin Francis, Hossu Gabriela, Bracard Serge
IADI, Université De Lorraine, INSERM, F-54000 Nancy, France.
Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan 430000, China.
Diagnostics (Basel). 2021 Nov 4;11(11):2038. doi: 10.3390/diagnostics11112038.
Pretreatment ischemic location may be an important determinant for functional outcome prediction in acute ischemic stroke. In total, 143 anterior circulation ischemic stroke patients in the THRACE study were included. Ischemic lesions were semi-automatically segmented on pretreatment diffusion-weighted imaging and registered on brain atlases. The percentage of ischemic tissue in each atlas-segmented region was calculated. Statistical models with logistic regression and support vector machine were built to analyze the predictors of functional outcome. The investigated parameters included: age, baseline National Institutes of Health Stroke Scale score, and lesional volume (three-parameter model), together with the ischemic percentage in each atlas-segmented region (four-parameter model). The support vector machine with radial basis functions outperformed logistic regression in prediction accuracy. The support vector machine three-parameter model demonstrated an area under the curve of 0.77, while the four-parameter model achieved a higher area under the curve (0.82). Regions with marked impacts on outcome prediction were the uncinate fasciculus, postcentral gyrus, putamen, middle occipital gyrus, supramarginal gyrus, and posterior corona radiata in the left hemisphere; and the uncinate fasciculus, paracentral lobule, temporal pole, hippocampus, inferior occipital gyrus, middle temporal gyrus, pallidum, and anterior limb of the internal capsule in the right hemisphere. In conclusion, pretreatment ischemic location provided significant prognostic information for functional outcome in ischemic stroke.
预处理缺血部位可能是急性缺血性卒中功能预后预测的重要决定因素。THRACE研究共纳入了143例前循环缺血性卒中患者。在预处理扩散加权成像上对缺血性病变进行半自动分割，并将其配准到脑图谱上。计算每个图谱分割区域内缺血组织的百分比。构建了逻辑回归和支持向量机的统计模型来分析功能预后的预测因素。研究参数包括：年龄、基线美国国立卫生研究院卒中量表评分和病变体积（三参数模型），以及每个图谱分割区域内的缺血百分比（四参数模型）。具有径向基函数的支持向量机在预测准确性方面优于逻辑回归。支持向量机三参数模型的曲线下面积为0.77，而四参数模型的曲线下面积更高（0.82）。对预后预测有显著影响的区域包括左半球的钩束、中央后回、壳核、枕中回、缘上回和放射冠后部；以及右半球的钩束、中央旁小叶、颞极、海马、枕下回、颞中回、苍白球和内囊前肢。总之，预处理缺血部位为缺血性卒中的功能预后提供了重要的预后信息。
