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Pracoviště: Department of Neuroradiology Vancouver General ...

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A Detailed Analysis of Infarct Patterns and Volumes at 24-hour Noncontrast CT and Diffusion-weighted MRI in Acute Ischemic Stroke Due to Large Vessel Occlusion: Results from the ESCAPE-NA1 Trial

Ospel, Johanna M
Autor Ospel, Johanna M From the Department of Clinical Neurosciences and Diagnostic Imaging, University of Calgary Cumming School of Medicine, 29th St NW, 1079 A, Calgary, AB, Canada T2N 2T9 (J.M.O., B.K.M., W.Q., N.K., A.M., N.S., P.C., M.M., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Radiology, University Hospital of Basel, Basel, Switzerland (J.M.O.) Department of Radiology, University of Calgary, Calgary, Alberta, Canada (B.K.M., N.K., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Medical Imaging, St Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic (P.C.) International Clinical Research Center, St Anne's University Hospital Brno, Czech Republic (P.C.) Department of Neurology, Emory University School of Medicine, Atlanta, Ga (R.G.N., D.H.) Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence, RI (R.A.M.) Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (A.Y.P., D.R., D.I.) Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (S.C.) Department of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada (A.R.) and NoNo, Toronto, Ontario, Canada (M.T.)
Menon, Bijoy K
Autor Menon, Bijoy K From the Department of Clinical Neurosciences and Diagnostic Imaging, University of Calgary Cumming School of Medicine, 29th St NW, 1079 A, Calgary, AB, Canada T2N 2T9 (J.M.O., B.K.M., W.Q., N.K., A.M., N.S., P.C., M.M., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Radiology, University Hospital of Basel, Basel, Switzerland (J.M.O.) Department of Radiology, University of Calgary, Calgary, Alberta, Canada (B.K.M., N.K., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Medical Imaging, St Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic (P.C.) International Clinical Research Center, St Anne's University Hospital Brno, Czech Republic (P.C.) Department of Neurology, Emory University School of Medicine, Atlanta, Ga (R.G.N., D.H.) Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence, RI (R.A.M.) Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (A.Y.P., D.R., D.I.) Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (S.C.) Department of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada (A.R.) and NoNo, Toronto, Ontario, Canada (M.T.)
Qiu, Wu
Autor Qiu, Wu From the Department of Clinical Neurosciences and Diagnostic Imaging, University of Calgary Cumming School of Medicine, 29th St NW, 1079 A, Calgary, AB, Canada T2N 2T9 (J.M.O., B.K.M., W.Q., N.K., A.M., N.S., P.C., M.M., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Radiology, University Hospital of Basel, Basel, Switzerland (J.M.O.) Department of Radiology, University of Calgary, Calgary, Alberta, Canada (B.K.M., N.K., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Medical Imaging, St Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic (P.C.) International Clinical Research Center, St Anne's University Hospital Brno, Czech Republic (P.C.) Department of Neurology, Emory University School of Medicine, Atlanta, Ga (R.G.N., D.H.) Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence, RI (R.A.M.) Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (A.Y.P., D.R., D.I.) Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (S.C.) Department of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada (A.R.) and NoNo, Toronto, Ontario, Canada (M.T.)
Kashani, Nima
Autor Kashani, Nima From the Department of Clinical Neurosciences and Diagnostic Imaging, University of Calgary Cumming School of Medicine, 29th St NW, 1079 A, Calgary, AB, Canada T2N 2T9 (J.M.O., B.K.M., W.Q., N.K., A.M., N.S., P.C., M.M., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Radiology, University Hospital of Basel, Basel, Switzerland (J.M.O.) Department of Radiology, University of Calgary, Calgary, Alberta, Canada (B.K.M., N.K., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Medical Imaging, St Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic (P.C.) International Clinical Research Center, St Anne's University Hospital Brno, Czech Republic (P.C.) Department of Neurology, Emory University School of Medicine, Atlanta, Ga (R.G.N., D.H.) Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence, RI (R.A.M.) Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (A.Y.P., D.R., D.I.) Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (S.C.) Department of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada (A.R.) and NoNo, Toronto, Ontario, Canada (M.T.)
Mayank, Arnuv
Autor Mayank, Arnuv From the Department of Clinical Neurosciences and Diagnostic Imaging, University of Calgary Cumming School of Medicine, 29th St NW, 1079 A, Calgary, AB, Canada T2N 2T9 (J.M.O., B.K.M., W.Q., N.K., A.M., N.S., P.C., M.M., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Radiology, University Hospital of Basel, Basel, Switzerland (J.M.O.) Department of Radiology, University of Calgary, Calgary, Alberta, Canada (B.K.M., N.K., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Medical Imaging, St Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic (P.C.) International Clinical Research Center, St Anne's University Hospital Brno, Czech Republic (P.C.) Department of Neurology, Emory University School of Medicine, Atlanta, Ga (R.G.N., D.H.) Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence, RI (R.A.M.) Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (A.Y.P., D.R., D.I.) Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (S.C.) Department of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada (A.R.) and NoNo, Toronto, Ontario, Canada (M.T.)
Singh, Nishita
Autor Singh, Nishita From the Department of Clinical Neurosciences and Diagnostic Imaging, University of Calgary Cumming School of Medicine, 29th St NW, 1079 A, Calgary, AB, Canada T2N 2T9 (J.M.O., B.K.M., W.Q., N.K., A.M., N.S., P.C., M.M., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Radiology, University Hospital of Basel, Basel, Switzerland (J.M.O.) Department of Radiology, University of Calgary, Calgary, Alberta, Canada (B.K.M., N.K., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Medical Imaging, St Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic (P.C.) International Clinical Research Center, St Anne's University Hospital Brno, Czech Republic (P.C.) Department of Neurology, Emory University School of Medicine, Atlanta, Ga (R.G.N., D.H.) Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence, RI (R.A.M.) Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (A.Y.P., D.R., D.I.) Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (S.C.) Department of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada (A.R.) and NoNo, Toronto, Ontario, Canada (M.T.)
Cimflova, Petra
Autor Cimflova, Petra From the Department of Clinical Neurosciences and Diagnostic Imaging, University of Calgary Cumming School of Medicine, 29th St NW, 1079 A, Calgary, AB, Canada T2N 2T9 (J.M.O., B.K.M., W.Q., N.K., A.M., N.S., P.C., M.M., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Radiology, University Hospital of Basel, Basel, Switzerland (J.M.O.) Department of Radiology, University of Calgary, Calgary, Alberta, Canada (B.K.M., N.K., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Medical Imaging, St Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic (P.C.) International Clinical Research Center, St Anne's University Hospital Brno, Czech Republic (P.C.) Department of Neurology, Emory University School of Medicine, Atlanta, Ga (R.G.N., D.H.) Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence, RI (R.A.M.) Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (A.Y.P., D.R., D.I.) Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (S.C.) Department of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada (A.R.) and NoNo, Toronto, Ontario, Canada (M.T.)
Marko, Martha
Autor Marko, Martha From the Department of Clinical Neurosciences and Diagnostic Imaging, University of Calgary Cumming School of Medicine, 29th St NW, 1079 A, Calgary, AB, Canada T2N 2T9 (J.M.O., B.K.M., W.Q., N.K., A.M., N.S., P.C., M.M., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Radiology, University Hospital of Basel, Basel, Switzerland (J.M.O.) Department of Radiology, University of Calgary, Calgary, Alberta, Canada (B.K.M., N.K., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Medical Imaging, St Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic (P.C.) International Clinical Research Center, St Anne's University Hospital Brno, Czech Republic (P.C.) Department of Neurology, Emory University School of Medicine, Atlanta, Ga (R.G.N., D.H.) Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence, RI (R.A.M.) Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (A.Y.P., D.R., D.I.) Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (S.C.) Department of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada (A.R.) and NoNo, Toronto, Ontario, Canada (M.T.)
Nogueira, Raul G
Autor Nogueira, Raul G From the Department of Clinical Neurosciences and Diagnostic Imaging, University of Calgary Cumming School of Medicine, 29th St NW, 1079 A, Calgary, AB, Canada T2N 2T9 (J.M.O., B.K.M., W.Q., N.K., A.M., N.S., P.C., M.M., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Radiology, University Hospital of Basel, Basel, Switzerland (J.M.O.) Department of Radiology, University of Calgary, Calgary, Alberta, Canada (B.K.M., N.K., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Medical Imaging, St Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic (P.C.) International Clinical Research Center, St Anne's University Hospital Brno, Czech Republic (P.C.) Department of Neurology, Emory University School of Medicine, Atlanta, Ga (R.G.N., D.H.) Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence, RI (R.A.M.) Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (A.Y.P., D.R., D.I.) Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (S.C.) Department of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada (A.R.) and NoNo, Toronto, Ontario, Canada (M.T.)
McTaggart, Ryan A
Autor McTaggart, Ryan A From the Department of Clinical Neurosciences and Diagnostic Imaging, University of Calgary Cumming School of Medicine, 29th St NW, 1079 A, Calgary, AB, Canada T2N 2T9 (J.M.O., B.K.M., W.Q., N.K., A.M., N.S., P.C., M.M., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Radiology, University Hospital of Basel, Basel, Switzerland (J.M.O.) Department of Radiology, University of Calgary, Calgary, Alberta, Canada (B.K.M., N.K., A.M.D., C.Z., M.J., M.A.A., S.B.C., M.D.H., M.G.) Department of Medical Imaging, St Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic (P.C.) International Clinical Research Center, St Anne's University Hospital Brno, Czech Republic (P.C.) Department of Neurology, Emory University School of Medicine, Atlanta, Ga (R.G.N., D.H.) Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence, RI (R.A.M.) Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (A.Y.P., D.R., D.I.) Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (S.C.) Department of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada (A.R.) and NoNo, Toronto, Ontario, Canada (M.T.)

Radiology. 2021 ; 300 (1) : 152-159. [pub] 20210511

ISSN 1527-1315
Medvik
Zdroj

Background The effect of infarct pattern on functional outcome in acute ischemic stroke is incompletely understood. Purpose To investigate the association of qualitative and quantitative infarct variables at 24-hour follow-up noncontrast CT and diffusion-weighted MRI with 90-day clinical outcome. Materials and Methods The Safety and Efficacy of Nerinetide in Subjects Undergoing Endovascular Thrombectomy for Stroke, or ESCAPE-NA1, randomized controlled trial enrolled patients with large-vessel-occlusion stroke undergoing mechanical thrombectomy from March 1, 2017, to August 12, 2019. In this post hoc analysis of the trial, qualitative infarct variables (predominantly gray [vs gray and white] matter involvement, corticospinal tract involvement, infarct structure [scattered vs territorial]) and total infarct volume were assessed at 24-hour follow-up noncontrast CT or diffusion-weighted MRI. White and gray matter infarct volumes were assessed in patients by using follow-up diffusion-weighted MRI. Infarct variables were compared between patients with and those without good outcome, defined as a modified Rankin Scale score of 0-2 at 90 days. The association of infarct variables with good outcome was determined with use of multivariable logistic regression. Separate regression models were used to report effect size estimates with adjustment for total infarct volume. Results Qualitative infarct variables were assessed in 1026 patients (mean age ± standard deviation, 69 years ± 13; 522 men) and quantitative infarct variables were assessed in a subgroup of 358 of 1026 patients (mean age, 67 years ± 13; 190 women). Patients with gray and white matter involvement (odds ratio [OR] after multivariable adjustment, 0.19; 95% CI: 0.14, 0.25; P < .001), corticospinal tract involvement (OR after multivariable adjustment, 0.06; 95% CI: 0.04, 0.10; P < .001), and territorial infarcts (OR after multivariable adjustment, 0.22; 95% CI: 0.14, 0.32; P < .001) were less likely to achieve good outcome, independent of total infarct volume. Conclusion Infarct confinement to the gray matter, corticospinal tract sparing, and scattered infarct structure at 24-hour noncontrast CT and diffusion-weighted MRI were highly predictive of good 90-day clinical outcome, independent of total infarct volume. Clinical trial registration no. NCT02930018 © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Mossa-Basha in this issue.

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