Multimodal imaging evaluation of early neurological deterioration following acute ischemic stroke

作者：Meien Jiang, Guo‐Min Li, Qinmeng He, Yulin Zhang, Wuming Li, Yunyu Gao, Jianhao Yan · 发表于：Quantitative Imaging in Medicine and Surgery · 年份：2024 · DOI：10.21037/qims-24-153 · 被引用次数：7 · 研究领域：Acute Ischemic Stroke Management、Traumatic Brain Injury and Neurovascular Disturbances、S100 Proteins and Annexins

Background: Early neurologic deterioration occurs in up to one-third of patients with acute ischemic stroke (IS), often leading to poor functional outcomes. At present, few studies have applied amide proton transfer (APT) imaging to the evaluation of early neurological deterioration (END). This study analyzed the value of computed tomography perfusion (CTP) combined with multimodal magnetic resonance imaging (MRI) in patients with acute IS with END. Methods: This retrospective study included patients with acute IS who were admitted to the neurology inpatient department in a tertiary hospital from October 2021 to June 2023. Patients with acute IS underwent CTP within 24 hours of stroke onset and MRI [arterial spin labeling (ASL), susceptibility-weighted imaging (SWI), and APT] within 7 days. END was defined as an elevation of ≥2 points on the National Institute of Health Stroke Scale (NIHSS) within 7 days of stroke onset. Univariable and multivariable analyses were used to compare clinical and imaging biomarkers in patients with acute IS with and without END. The performance of potential biomarkers in distinguishing between the two groups was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Among the 70 patients with acute IS, 20 (29%) had END. After conducting univariable analysis, variables were selected for entry into a binary logistic regression analysis based on our univariable analysis results, previous research findings, clinical experien...