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Prognostic value of the baseline magnetic resonance score in patients with acute posterior circulation ischaemic stroke after mechanical thrombectomy.

Authors :
Huang, S.
Bai, B.
Yan, Y.
Gao, Y.
Xi, X.
Shi, H.
He, H.
Wang, S.
Yang, J.
Li, Y.
Source :
Clinical Radiology. Jan2024, Vol. 79 Issue 1, pe112-e118. 7p.
Publication Year :
2024

Abstract

To investigate the prognostic value of the composite posterior circulation Acute Stroke Prognosis Early Computed tomography (CT) Score (ASPECTS)-Collaterals (pcASCO) score, which combines diffusion-weighted imaging (DWI) posterior circulation ASPECTS (pcASPECTS) and the magnetic resonance angiography (MRA)-collateral circulation score at baseline among patients with acute posterior circulation ischaemic stroke after mechanical thrombectomy. Patients with acute posterior circulation ischaemic stroke who underwent mechanical thrombectomy were analysed retrospectively. The DWI-pcASPECTS and MRA-collateral circulation score before treatment and the modified Rankin Scale (mRS) at 90 days after treatment were used as the endpoints. An mRS ≤2 was defined as a good prognosis, and an mRS ≥3 was defined as a poor prognosis. Multivariate logistic regression was used to analyse independent predictors of functional outcome 90 days after mechanical thrombectomy. Mechanical thrombectomy was performed in 57 patients; 38 patients had a good prognosis, 19 patients had a poor prognosis, and 33 patients were successfully recanalised. Univariate logistic regression found that National Institute of Health Stroke Scale (NIHSS) score (OR: 1.18, p< 0.001), pcASPECTS (OR: 1.91, p= 0.028) and pcASCO score (OR: 0.51, p= 0.001) were factors of good functional outcome. Receiver operating characteristic curve (ROC curve) analysis showed that the diagnostic efficiency of the NIHSS and pcASCO was better (AUC = 0.88, 0.83, p< 0.05) than that of the pcASPECTS (AUC = 0.65). The prediction model was established by age, NIHSS, and pcASCO, and the diagnostic efficiency of the prediction model was better (AUC = 0.94). The composite MR-pcASCO score can be used as an important predictor of the prognosis of patients with acute posterior circulation ischaemic stroke after mechanical thrombectomy. • pcASCO can be used as a simple and feasible imaging tool. • pcASCO may predict clinical outcomes and provide treatment guidance. • The NIHSS score and pcASCO score were independent predictors of good functional outcome. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00099260
Volume :
79
Issue :
1
Database :
Academic Search Index
Journal :
Clinical Radiology
Publication Type :
Academic Journal
Accession number :
174317629
Full Text :
https://doi.org/10.1016/j.crad.2023.09.023