How Topographic Diffusion-Weighted Imaging Patterns can Predict the Potential Embolic Source
Purpose To develop an imaging prediction model for patients with embolic stroke of undetermined source (ESUS), we investigated the association of topographic diffusion-weighted imaging (DWI) patterns with potential embolic sources (PES) identified by transesophageal echocardiography. Methods From a ...
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| Veröffentlicht in: | Clinical neuroradiology (Munich) 2024-06, Vol.34 (2), p.363-371 |
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| creator | Yamamoto, Y Nagakane, Y Tanaka, E Yamada, T Fujinami, J Ohara, T |
| description | Purpose
To develop an imaging prediction model for patients with embolic stroke of undetermined source (ESUS), we investigated the association of topographic diffusion-weighted imaging (DWI) patterns with potential embolic sources (PES) identified by transesophageal echocardiography.
Methods
From a total of 992 consecutive patients with embolic stroke, 366 patients with the ESUS group were selected. ESUS was defined as no atrial fibrillation (Af) within 24h from admission and no PES after general examination. Clinical variables include age (> 80years, 70–80 years), sex, vascular risk factors and left atrial diameter > 4 cm. Age, sex and vascular risk factors adjusted odds ratio of each DWI for the different PESs were calculated. DWI was determined based on the arterial territories. Middle cerebral arteries were divided into 4 segments, i.e., M1–M4. Moreover, M2 segments were subdivided into superior and inferior branches.
Results
The 366 patients consisted of 168 with paroxysmal Af (pAf), 77 with paradoxical embolism, 71 with aortic embolism and 50 with undetermined embolism after transesophageal echocardiography. The variables adjusted odds ratio (OR) of internal carotid artery (OR: 12.1,
p
= 0.037), M1 (4.2,
p
= 0.001), inferior M2 (7.5,
p
= 0.0041) and multiple cortical branches (12.6,
p
|
| doi_str_mv | 10.1007/s00062-023-01366-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2910193651</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2910193651</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-3af57fc7a9574fa1c8ccb3d86fcefc3dff70973ae471dfb3df440962fae7e4123</originalsourceid><addsrcrecordid>eNp9kNFqFTEQhoNY2lL7Ar2QBW-8WTtJdpPNpdTWFgo9YMUrCTnZyZ6U3c0xySL2afosPpnRUyt40asZmG_-GT5CTii8owDyNAGAYDUwXgPlQtT3L8gh7YSqadPIl089VwfkOKW7ggPvVNvKfXLAOyoUADskXy_D9-o2bMMQzXbjbfXBO7ckH-b6C_phk7GvriYz-HmoViZnjHOqrJmrVcTe21zlDf58WIWMc_ZmrM6ndRhLzKewRIuvyJ4zY8Ljx3pEPl-c355d1tc3H6_O3l_XljORa25cK52VRrWycYbazto17zvhLDrLe-ckKMkNNpL2rkxc04ASzBmU2FDGj8jbXe42hm8LpqwnnyyOo5kxLEkzRYEqLlpa0Df_oXfl1bl8pzkIEFQxzgvFdpSNIaWITm-jn0z8oSno3_71zr8u_vUf__q-LL1-jF7WE_ZPK39tF4DvgFRG84Dx3-1nYn8Bg72SRg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3060619233</pqid></control><display><type>article</type><title>How Topographic Diffusion-Weighted Imaging Patterns can Predict the Potential Embolic Source</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Yamamoto, Y ; Nagakane, Y ; Tanaka, E ; Yamada, T ; Fujinami, J ; Ohara, T</creator><creatorcontrib>Yamamoto, Y ; Nagakane, Y ; Tanaka, E ; Yamada, T ; Fujinami, J ; Ohara, T</creatorcontrib><description>Purpose
To develop an imaging prediction model for patients with embolic stroke of undetermined source (ESUS), we investigated the association of topographic diffusion-weighted imaging (DWI) patterns with potential embolic sources (PES) identified by transesophageal echocardiography.
Methods
From a total of 992 consecutive patients with embolic stroke, 366 patients with the ESUS group were selected. ESUS was defined as no atrial fibrillation (Af) within 24h from admission and no PES after general examination. Clinical variables include age (> 80years, 70–80 years), sex, vascular risk factors and left atrial diameter > 4 cm. Age, sex and vascular risk factors adjusted odds ratio of each DWI for the different PESs were calculated. DWI was determined based on the arterial territories. Middle cerebral arteries were divided into 4 segments, i.e., M1–M4. Moreover, M2 segments were subdivided into superior and inferior branches.
Results
The 366 patients consisted of 168 with paroxysmal Af (pAf), 77 with paradoxical embolism, 71 with aortic embolism and 50 with undetermined embolism after transesophageal echocardiography. The variables adjusted odds ratio (OR) of internal carotid artery (OR: 12.1,
p
= 0.037), M1 (4.2,
p
= 0.001), inferior M2 (7.5,
p
= 0.0041) and multiple cortical branches (12.6,
p
< 0.0001) were significantly higher in patients with pAf. Striatocapsular infarction (12.5,
p
< 0.0001) and posterior inferior cerebellar artery infarcts (3.6,
p
= 0.018) were significantly associated with paradoxical embolism. Clinical variables adjusted OR of multiple small scattered infarcts (8.3,
p
< 0.0001) were significantly higher in patients with aortic embolism.
Conclusion
The associations of DWI with different PES have their distinctive characteristics and DWI along with clinical variables may help predict PES in patients with ESUS.</description><identifier>ISSN: 1869-1439</identifier><identifier>ISSN: 1869-1447</identifier><identifier>EISSN: 1869-1447</identifier><identifier>DOI: 10.1007/s00062-023-01366-z</identifier><identifier>PMID: 38169002</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aged, 80 and over ; Atrial Fibrillation - diagnostic imaging ; Embolic Stroke - diagnostic imaging ; Embolic Stroke - epidemiology ; Embolisms ; Humans ; Intracranial Embolism - diagnostic imaging ; Logistic Models ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Male ; Medicine ; Medicine & Public Health ; Neurology ; Neuroradiology ; Neurosurgery ; Odds Ratio ; Original Article ; Topography ; Veins & arteries</subject><ispartof>Clinical neuroradiology (Munich), 2024-06, Vol.34 (2), p.363-371</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-3af57fc7a9574fa1c8ccb3d86fcefc3dff70973ae471dfb3df440962fae7e4123</cites><orcidid>0000-0001-8122-007X ; 0000-0002-8116-4730 ; 0000-0001-5561-5131 ; 0000-0001-5196-1934 ; 0000-0001-6905-6406 ; 0000-0003-2203-7077</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00062-023-01366-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00062-023-01366-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38169002$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yamamoto, Y</creatorcontrib><creatorcontrib>Nagakane, Y</creatorcontrib><creatorcontrib>Tanaka, E</creatorcontrib><creatorcontrib>Yamada, T</creatorcontrib><creatorcontrib>Fujinami, J</creatorcontrib><creatorcontrib>Ohara, T</creatorcontrib><title>How Topographic Diffusion-Weighted Imaging Patterns can Predict the Potential Embolic Source</title><title>Clinical neuroradiology (Munich)</title><addtitle>Clin Neuroradiol</addtitle><addtitle>Clin Neuroradiol</addtitle><description>Purpose
To develop an imaging prediction model for patients with embolic stroke of undetermined source (ESUS), we investigated the association of topographic diffusion-weighted imaging (DWI) patterns with potential embolic sources (PES) identified by transesophageal echocardiography.
Methods
From a total of 992 consecutive patients with embolic stroke, 366 patients with the ESUS group were selected. ESUS was defined as no atrial fibrillation (Af) within 24h from admission and no PES after general examination. Clinical variables include age (> 80years, 70–80 years), sex, vascular risk factors and left atrial diameter > 4 cm. Age, sex and vascular risk factors adjusted odds ratio of each DWI for the different PESs were calculated. DWI was determined based on the arterial territories. Middle cerebral arteries were divided into 4 segments, i.e., M1–M4. Moreover, M2 segments were subdivided into superior and inferior branches.
Results
The 366 patients consisted of 168 with paroxysmal Af (pAf), 77 with paradoxical embolism, 71 with aortic embolism and 50 with undetermined embolism after transesophageal echocardiography. The variables adjusted odds ratio (OR) of internal carotid artery (OR: 12.1,
p
= 0.037), M1 (4.2,
p
= 0.001), inferior M2 (7.5,
p
= 0.0041) and multiple cortical branches (12.6,
p
< 0.0001) were significantly higher in patients with pAf. Striatocapsular infarction (12.5,
p
< 0.0001) and posterior inferior cerebellar artery infarcts (3.6,
p
= 0.018) were significantly associated with paradoxical embolism. Clinical variables adjusted OR of multiple small scattered infarcts (8.3,
p
< 0.0001) were significantly higher in patients with aortic embolism.
Conclusion
The associations of DWI with different PES have their distinctive characteristics and DWI along with clinical variables may help predict PES in patients with ESUS.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Atrial Fibrillation - diagnostic imaging</subject><subject>Embolic Stroke - diagnostic imaging</subject><subject>Embolic Stroke - epidemiology</subject><subject>Embolisms</subject><subject>Humans</subject><subject>Intracranial Embolism - diagnostic imaging</subject><subject>Logistic Models</subject><subject>Magnetic Resonance Angiography</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosurgery</subject><subject>Odds Ratio</subject><subject>Original Article</subject><subject>Topography</subject><subject>Veins & arteries</subject><issn>1869-1439</issn><issn>1869-1447</issn><issn>1869-1447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kNFqFTEQhoNY2lL7Ar2QBW-8WTtJdpPNpdTWFgo9YMUrCTnZyZ6U3c0xySL2afosPpnRUyt40asZmG_-GT5CTii8owDyNAGAYDUwXgPlQtT3L8gh7YSqadPIl089VwfkOKW7ggPvVNvKfXLAOyoUADskXy_D9-o2bMMQzXbjbfXBO7ckH-b6C_phk7GvriYz-HmoViZnjHOqrJmrVcTe21zlDf58WIWMc_ZmrM6ndRhLzKewRIuvyJ4zY8Ljx3pEPl-c355d1tc3H6_O3l_XljORa25cK52VRrWycYbazto17zvhLDrLe-ckKMkNNpL2rkxc04ASzBmU2FDGj8jbXe42hm8LpqwnnyyOo5kxLEkzRYEqLlpa0Df_oXfl1bl8pzkIEFQxzgvFdpSNIaWITm-jn0z8oSno3_71zr8u_vUf__q-LL1-jF7WE_ZPK39tF4DvgFRG84Dx3-1nYn8Bg72SRg</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>Yamamoto, Y</creator><creator>Nagakane, Y</creator><creator>Tanaka, E</creator><creator>Yamada, T</creator><creator>Fujinami, J</creator><creator>Ohara, T</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8122-007X</orcidid><orcidid>https://orcid.org/0000-0002-8116-4730</orcidid><orcidid>https://orcid.org/0000-0001-5561-5131</orcidid><orcidid>https://orcid.org/0000-0001-5196-1934</orcidid><orcidid>https://orcid.org/0000-0001-6905-6406</orcidid><orcidid>https://orcid.org/0000-0003-2203-7077</orcidid></search><sort><creationdate>20240601</creationdate><title>How Topographic Diffusion-Weighted Imaging Patterns can Predict the Potential Embolic Source</title><author>Yamamoto, Y ; Nagakane, Y ; Tanaka, E ; Yamada, T ; Fujinami, J ; Ohara, T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-3af57fc7a9574fa1c8ccb3d86fcefc3dff70973ae471dfb3df440962fae7e4123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Atrial Fibrillation - diagnostic imaging</topic><topic>Embolic Stroke - diagnostic imaging</topic><topic>Embolic Stroke - epidemiology</topic><topic>Embolisms</topic><topic>Humans</topic><topic>Intracranial Embolism - diagnostic imaging</topic><topic>Logistic Models</topic><topic>Magnetic Resonance Angiography</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosurgery</topic><topic>Odds Ratio</topic><topic>Original Article</topic><topic>Topography</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yamamoto, Y</creatorcontrib><creatorcontrib>Nagakane, Y</creatorcontrib><creatorcontrib>Tanaka, E</creatorcontrib><creatorcontrib>Yamada, T</creatorcontrib><creatorcontrib>Fujinami, J</creatorcontrib><creatorcontrib>Ohara, T</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical neuroradiology (Munich)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamamoto, Y</au><au>Nagakane, Y</au><au>Tanaka, E</au><au>Yamada, T</au><au>Fujinami, J</au><au>Ohara, T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How Topographic Diffusion-Weighted Imaging Patterns can Predict the Potential Embolic Source</atitle><jtitle>Clinical neuroradiology (Munich)</jtitle><stitle>Clin Neuroradiol</stitle><addtitle>Clin Neuroradiol</addtitle><date>2024-06-01</date><risdate>2024</risdate><volume>34</volume><issue>2</issue><spage>363</spage><epage>371</epage><pages>363-371</pages><issn>1869-1439</issn><issn>1869-1447</issn><eissn>1869-1447</eissn><abstract>Purpose
To develop an imaging prediction model for patients with embolic stroke of undetermined source (ESUS), we investigated the association of topographic diffusion-weighted imaging (DWI) patterns with potential embolic sources (PES) identified by transesophageal echocardiography.
Methods
From a total of 992 consecutive patients with embolic stroke, 366 patients with the ESUS group were selected. ESUS was defined as no atrial fibrillation (Af) within 24h from admission and no PES after general examination. Clinical variables include age (> 80years, 70–80 years), sex, vascular risk factors and left atrial diameter > 4 cm. Age, sex and vascular risk factors adjusted odds ratio of each DWI for the different PESs were calculated. DWI was determined based on the arterial territories. Middle cerebral arteries were divided into 4 segments, i.e., M1–M4. Moreover, M2 segments were subdivided into superior and inferior branches.
Results
The 366 patients consisted of 168 with paroxysmal Af (pAf), 77 with paradoxical embolism, 71 with aortic embolism and 50 with undetermined embolism after transesophageal echocardiography. The variables adjusted odds ratio (OR) of internal carotid artery (OR: 12.1,
p
= 0.037), M1 (4.2,
p
= 0.001), inferior M2 (7.5,
p
= 0.0041) and multiple cortical branches (12.6,
p
< 0.0001) were significantly higher in patients with pAf. Striatocapsular infarction (12.5,
p
< 0.0001) and posterior inferior cerebellar artery infarcts (3.6,
p
= 0.018) were significantly associated with paradoxical embolism. Clinical variables adjusted OR of multiple small scattered infarcts (8.3,
p
< 0.0001) were significantly higher in patients with aortic embolism.
Conclusion
The associations of DWI with different PES have their distinctive characteristics and DWI along with clinical variables may help predict PES in patients with ESUS.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38169002</pmid><doi>10.1007/s00062-023-01366-z</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8122-007X</orcidid><orcidid>https://orcid.org/0000-0002-8116-4730</orcidid><orcidid>https://orcid.org/0000-0001-5561-5131</orcidid><orcidid>https://orcid.org/0000-0001-5196-1934</orcidid><orcidid>https://orcid.org/0000-0001-6905-6406</orcidid><orcidid>https://orcid.org/0000-0003-2203-7077</orcidid></addata></record> |
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| subjects | Aged Aged, 80 and over Atrial Fibrillation - diagnostic imaging Embolic Stroke - diagnostic imaging Embolic Stroke - epidemiology Embolisms Humans Intracranial Embolism - diagnostic imaging Logistic Models Magnetic Resonance Angiography Magnetic Resonance Imaging Male Medicine Medicine & Public Health Neurology Neuroradiology Neurosurgery Odds Ratio Original Article Topography Veins & arteries |
| title | How Topographic Diffusion-Weighted Imaging Patterns can Predict the Potential Embolic Source |
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