Ipsilateral Prominent Thalamostriate Vein on Susceptibility-Weighted Imaging Predicts Poor Outcome after Intravenous Thrombolysis in Acute Ischemic Stroke
The impact of deep cerebral veins on neurologic outcome after intravenous thrombolysis in patients with acute ischemic stroke is unclear. We investigated the relationship between the appearance of deep cerebral veins on susceptibility-weighted imaging and neurologic outcome in patients who underwent...
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| Veröffentlicht in: | American journal of neuroradiology : AJNR 2017-05, Vol.38 (5), p.875-881 |
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| creator | Zhang, X Zhang, S Chen, Q Ding, W Campbell, B C V Lou, M |
| description | The impact of deep cerebral veins on neurologic outcome after intravenous thrombolysis in patients with acute ischemic stroke is unclear. We investigated the relationship between the appearance of deep cerebral veins on susceptibility-weighted imaging and neurologic outcome in patients who underwent thrombolysis.
We retrospectively analyzed 109 consecutive patients with acute ischemic stroke who had pretreatment SWI and received intravenous thrombolysis within 6 hours. We calculated the signal difference ratio (defined as the relative difference in signal intensity between the ipsilateral and contralateral veins) of the thalamostriate vein, septal vein, and internal cerebral vein on pretreatment SWI.
Only the signal difference ratio of the thalamostriate vein was significantly associated with poor outcome (3-month modified Rankin Scale score > 2,
= .008). The optimal threshold was relative hypointensity of the ipsilateral vein of >4.8% (sensitivity of 53.7% and specificity of 80.9%). We defined a signal difference ratio of the thalamostriate vein of ≥5% as an ipsilateral prominent thalamostriate vein. Patients with an ipsilateral prominent thalamostriate vein were more likely to have poor outcome (OR = 3.66; 95% CI, 1.25-10.68;
= .02) and a lower rate of successful reperfusion (reperfusion rate of ≥70%; OR = 0.35; 95% CI, 0.13-0.92;
= .03), compared with those without an ipsilateral prominent thalamostriate vein. However, patients with an ipsilateral prominent thalamostriate vein were still less likely to experience poor outcome when reperfusion was achieved compared with when reperfusion did not occur (80.0% versus 44.4%,
= .04).
A pretreatment ipsilateral prominent thalamostriate vein was associated with reduced reperfusion after thrombolysis and poor outcome. More intensive reperfusion approaches may be required for patients with an ipsilateral prominent thalamostriate vein. |
| doi_str_mv | 10.3174/ajnr.a5135 |
| format | Article |
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We retrospectively analyzed 109 consecutive patients with acute ischemic stroke who had pretreatment SWI and received intravenous thrombolysis within 6 hours. We calculated the signal difference ratio (defined as the relative difference in signal intensity between the ipsilateral and contralateral veins) of the thalamostriate vein, septal vein, and internal cerebral vein on pretreatment SWI.
Only the signal difference ratio of the thalamostriate vein was significantly associated with poor outcome (3-month modified Rankin Scale score > 2,
= .008). The optimal threshold was relative hypointensity of the ipsilateral vein of >4.8% (sensitivity of 53.7% and specificity of 80.9%). We defined a signal difference ratio of the thalamostriate vein of ≥5% as an ipsilateral prominent thalamostriate vein. Patients with an ipsilateral prominent thalamostriate vein were more likely to have poor outcome (OR = 3.66; 95% CI, 1.25-10.68;
= .02) and a lower rate of successful reperfusion (reperfusion rate of ≥70%; OR = 0.35; 95% CI, 0.13-0.92;
= .03), compared with those without an ipsilateral prominent thalamostriate vein. However, patients with an ipsilateral prominent thalamostriate vein were still less likely to experience poor outcome when reperfusion was achieved compared with when reperfusion did not occur (80.0% versus 44.4%,
= .04).
A pretreatment ipsilateral prominent thalamostriate vein was associated with reduced reperfusion after thrombolysis and poor outcome. More intensive reperfusion approaches may be required for patients with an ipsilateral prominent thalamostriate vein.</description><identifier>ISSN: 0195-6108</identifier><identifier>EISSN: 1936-959X</identifier><identifier>DOI: 10.3174/ajnr.a5135</identifier><identifier>PMID: 28302608</identifier><language>eng</language><publisher>United States: American Society of Neuroradiology</publisher><subject>Adult Brain ; Aged ; Brain Ischemia - drug therapy ; Brain Ischemia - pathology ; Cerebral Veins - diagnostic imaging ; Cerebral Veins - pathology ; Female ; Humans ; Intravenous administration ; Ischemia ; Male ; Middle Aged ; Patients ; Reperfusion ; Retrospective Studies ; Stroke ; Stroke - drug therapy ; Stroke - pathology ; Thrombolysis ; Thrombolytic Therapy - methods ; Treatment Outcome ; Veins</subject><ispartof>American journal of neuroradiology : AJNR, 2017-05, Vol.38 (5), p.875-881</ispartof><rights>2017 by American Journal of Neuroradiology.</rights><rights>Copyright American Society of Neuroradiology May 2017</rights><rights>2017 by American Journal of Neuroradiology 2017 American Journal of Neuroradiology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4205-f98fb995e0f0dd12228182d4034c76bfa19f51d63dd4aa6cec6c2ff8e4597b413</citedby><cites>FETCH-LOGICAL-c4205-f98fb995e0f0dd12228182d4034c76bfa19f51d63dd4aa6cec6c2ff8e4597b413</cites><orcidid>0000-0001-8082-4154 ; 0000-0002-5702-0331 ; 0000-0003-3632-9433 ; 0000-0003-0644-7930 ; 0000-0002-6393-6725 ; 0000-0002-6627-064X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7960373/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7960373/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28302608$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, X</creatorcontrib><creatorcontrib>Zhang, S</creatorcontrib><creatorcontrib>Chen, Q</creatorcontrib><creatorcontrib>Ding, W</creatorcontrib><creatorcontrib>Campbell, B C V</creatorcontrib><creatorcontrib>Lou, M</creatorcontrib><title>Ipsilateral Prominent Thalamostriate Vein on Susceptibility-Weighted Imaging Predicts Poor Outcome after Intravenous Thrombolysis in Acute Ischemic Stroke</title><title>American journal of neuroradiology : AJNR</title><addtitle>AJNR Am J Neuroradiol</addtitle><description>The impact of deep cerebral veins on neurologic outcome after intravenous thrombolysis in patients with acute ischemic stroke is unclear. We investigated the relationship between the appearance of deep cerebral veins on susceptibility-weighted imaging and neurologic outcome in patients who underwent thrombolysis.
We retrospectively analyzed 109 consecutive patients with acute ischemic stroke who had pretreatment SWI and received intravenous thrombolysis within 6 hours. We calculated the signal difference ratio (defined as the relative difference in signal intensity between the ipsilateral and contralateral veins) of the thalamostriate vein, septal vein, and internal cerebral vein on pretreatment SWI.
Only the signal difference ratio of the thalamostriate vein was significantly associated with poor outcome (3-month modified Rankin Scale score > 2,
= .008). The optimal threshold was relative hypointensity of the ipsilateral vein of >4.8% (sensitivity of 53.7% and specificity of 80.9%). We defined a signal difference ratio of the thalamostriate vein of ≥5% as an ipsilateral prominent thalamostriate vein. Patients with an ipsilateral prominent thalamostriate vein were more likely to have poor outcome (OR = 3.66; 95% CI, 1.25-10.68;
= .02) and a lower rate of successful reperfusion (reperfusion rate of ≥70%; OR = 0.35; 95% CI, 0.13-0.92;
= .03), compared with those without an ipsilateral prominent thalamostriate vein. However, patients with an ipsilateral prominent thalamostriate vein were still less likely to experience poor outcome when reperfusion was achieved compared with when reperfusion did not occur (80.0% versus 44.4%,
= .04).
A pretreatment ipsilateral prominent thalamostriate vein was associated with reduced reperfusion after thrombolysis and poor outcome. More intensive reperfusion approaches may be required for patients with an ipsilateral prominent thalamostriate vein.</description><subject>Adult Brain</subject><subject>Aged</subject><subject>Brain Ischemia - drug therapy</subject><subject>Brain Ischemia - pathology</subject><subject>Cerebral Veins - diagnostic imaging</subject><subject>Cerebral Veins - pathology</subject><subject>Female</subject><subject>Humans</subject><subject>Intravenous administration</subject><subject>Ischemia</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Reperfusion</subject><subject>Retrospective Studies</subject><subject>Stroke</subject><subject>Stroke - drug therapy</subject><subject>Stroke - pathology</subject><subject>Thrombolysis</subject><subject>Thrombolytic Therapy - methods</subject><subject>Treatment Outcome</subject><subject>Veins</subject><issn>0195-6108</issn><issn>1936-959X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkslqHDEQhpuQEI-dXPIAQZBLCLSjpRfpEhhMlgaDDXaWm1CrSzOadEtjSW2YV_HTRo0dk-SSkw718VWp6i-KVwSfMtJW79XOhVNVE1Y_KVZEsKYUtfjxtFhhIuqyIZgfFccx7jDGtWjp8-KIcoZpg_mquOv20Y4qQVAjugx-sg5cQtdbNarJxxRsrqFvYB3yDl3NUcM-2d6ONh3K72A32wQD6ia1sW6TBTBYnSK69D6gizlpPwFSJutR51JQt-D8HLM-d-r9eIg2oqxe6zl36aLewmQ1ukrB_4QXxTOjxggvH96T4uunj9dnX8rzi8_d2fq81BXFdWkEN70QNWCDh4FQSjnhdKgwq3Tb9EYRYWoyNGwYKqUaDbrR1BgOVV5GXxF2Uny49-7nfoJBwzLoKPfBTiocpFdW_l1xdis3_la2osGsZVnw9kEQ_M0MMcnJ5j2No3KQfyuJwPlMlLfk_yhvOaeUCJrRN_-gOz8HlzeRhZzkU3KyUO_uKR18jAHM49wEyyUdckmHXC_pyPDrP3_6iP6OA_sFakq6Nw</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Zhang, X</creator><creator>Zhang, S</creator><creator>Chen, Q</creator><creator>Ding, W</creator><creator>Campbell, B C V</creator><creator>Lou, M</creator><general>American Society of Neuroradiology</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>7QO</scope><scope>7QP</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8082-4154</orcidid><orcidid>https://orcid.org/0000-0002-5702-0331</orcidid><orcidid>https://orcid.org/0000-0003-3632-9433</orcidid><orcidid>https://orcid.org/0000-0003-0644-7930</orcidid><orcidid>https://orcid.org/0000-0002-6393-6725</orcidid><orcidid>https://orcid.org/0000-0002-6627-064X</orcidid></search><sort><creationdate>20170501</creationdate><title>Ipsilateral Prominent Thalamostriate Vein on Susceptibility-Weighted Imaging Predicts Poor Outcome after Intravenous Thrombolysis in Acute Ischemic Stroke</title><author>Zhang, X ; Zhang, S ; Chen, Q ; Ding, W ; Campbell, B C V ; Lou, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4205-f98fb995e0f0dd12228182d4034c76bfa19f51d63dd4aa6cec6c2ff8e4597b413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult Brain</topic><topic>Aged</topic><topic>Brain Ischemia - drug therapy</topic><topic>Brain Ischemia - pathology</topic><topic>Cerebral Veins - diagnostic imaging</topic><topic>Cerebral Veins - pathology</topic><topic>Female</topic><topic>Humans</topic><topic>Intravenous administration</topic><topic>Ischemia</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Reperfusion</topic><topic>Retrospective Studies</topic><topic>Stroke</topic><topic>Stroke - drug therapy</topic><topic>Stroke - pathology</topic><topic>Thrombolysis</topic><topic>Thrombolytic Therapy - methods</topic><topic>Treatment Outcome</topic><topic>Veins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, X</creatorcontrib><creatorcontrib>Zhang, S</creatorcontrib><creatorcontrib>Chen, Q</creatorcontrib><creatorcontrib>Ding, W</creatorcontrib><creatorcontrib>Campbell, B C V</creatorcontrib><creatorcontrib>Lou, M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of neuroradiology : AJNR</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, X</au><au>Zhang, S</au><au>Chen, Q</au><au>Ding, W</au><au>Campbell, B C V</au><au>Lou, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ipsilateral Prominent Thalamostriate Vein on Susceptibility-Weighted Imaging Predicts Poor Outcome after Intravenous Thrombolysis in Acute Ischemic Stroke</atitle><jtitle>American journal of neuroradiology : AJNR</jtitle><addtitle>AJNR Am J Neuroradiol</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>38</volume><issue>5</issue><spage>875</spage><epage>881</epage><pages>875-881</pages><issn>0195-6108</issn><eissn>1936-959X</eissn><abstract>The impact of deep cerebral veins on neurologic outcome after intravenous thrombolysis in patients with acute ischemic stroke is unclear. We investigated the relationship between the appearance of deep cerebral veins on susceptibility-weighted imaging and neurologic outcome in patients who underwent thrombolysis.
We retrospectively analyzed 109 consecutive patients with acute ischemic stroke who had pretreatment SWI and received intravenous thrombolysis within 6 hours. We calculated the signal difference ratio (defined as the relative difference in signal intensity between the ipsilateral and contralateral veins) of the thalamostriate vein, septal vein, and internal cerebral vein on pretreatment SWI.
Only the signal difference ratio of the thalamostriate vein was significantly associated with poor outcome (3-month modified Rankin Scale score > 2,
= .008). The optimal threshold was relative hypointensity of the ipsilateral vein of >4.8% (sensitivity of 53.7% and specificity of 80.9%). We defined a signal difference ratio of the thalamostriate vein of ≥5% as an ipsilateral prominent thalamostriate vein. Patients with an ipsilateral prominent thalamostriate vein were more likely to have poor outcome (OR = 3.66; 95% CI, 1.25-10.68;
= .02) and a lower rate of successful reperfusion (reperfusion rate of ≥70%; OR = 0.35; 95% CI, 0.13-0.92;
= .03), compared with those without an ipsilateral prominent thalamostriate vein. However, patients with an ipsilateral prominent thalamostriate vein were still less likely to experience poor outcome when reperfusion was achieved compared with when reperfusion did not occur (80.0% versus 44.4%,
= .04).
A pretreatment ipsilateral prominent thalamostriate vein was associated with reduced reperfusion after thrombolysis and poor outcome. More intensive reperfusion approaches may be required for patients with an ipsilateral prominent thalamostriate vein.</abstract><cop>United States</cop><pub>American Society of Neuroradiology</pub><pmid>28302608</pmid><doi>10.3174/ajnr.a5135</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8082-4154</orcidid><orcidid>https://orcid.org/0000-0002-5702-0331</orcidid><orcidid>https://orcid.org/0000-0003-3632-9433</orcidid><orcidid>https://orcid.org/0000-0003-0644-7930</orcidid><orcidid>https://orcid.org/0000-0002-6393-6725</orcidid><orcidid>https://orcid.org/0000-0002-6627-064X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Brain Aged Brain Ischemia - drug therapy Brain Ischemia - pathology Cerebral Veins - diagnostic imaging Cerebral Veins - pathology Female Humans Intravenous administration Ischemia Male Middle Aged Patients Reperfusion Retrospective Studies Stroke Stroke - drug therapy Stroke - pathology Thrombolysis Thrombolytic Therapy - methods Treatment Outcome Veins |
| title | Ipsilateral Prominent Thalamostriate Vein on Susceptibility-Weighted Imaging Predicts Poor Outcome after Intravenous Thrombolysis in Acute Ischemic Stroke |
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