Diffusion-weighted imaging score of the brain stem: A predictor of outcome in acute basilar artery occlusion treated with the Solitaire FR device
The prognosis for ischemic stroke due to acute basilar artery occlusion is very poor: Early recanalization remains the main factor that can improve outcomes. The baseline extent of brain stem ischemic damage can also influence outcomes. We evaluated the validity of an easy-to-use DWI score to predic...
Gespeichert in:
| Veröffentlicht in: | American journal of neuroradiology : AJNR 2014-06, Vol.35 (6), p.1117-1123 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1123 |
|---|---|
| container_issue | 6 |
| container_start_page | 1117 |
| container_title | American journal of neuroradiology : AJNR |
| container_volume | 35 |
| creator | Mourand, I Machi, P Nogué, E Arquizan, C Costalat, V Picot, M-C Bonafé, A Milhaud, D |
| description | The prognosis for ischemic stroke due to acute basilar artery occlusion is very poor: Early recanalization remains the main factor that can improve outcomes. The baseline extent of brain stem ischemic damage can also influence outcomes. We evaluated the validity of an easy-to-use DWI score to predict clinical outcome in patients with acute basilar artery occlusion treated by mechanical thrombectomy.
We analyzed the baseline clinical and DWI parameters of 31 patients with acute basilar artery occlusion, treated within 24 hours of symptom onset by using a Solitaire FR device. The DWI score of the brain stem was assessed with a 12-point semiquantitative score that separately considered each side of the medulla, pons, and midbrain. Clinical outcome was assessed at 180 days by using the mRS. According to receiver operating characteristic analyses, the cutoff score determined the optimal positive predictive value for outcome. The Spearman rank correlation coefficient assessed the correlation between the DWI brain stem score and baseline characteristics.
Successful recanalization (Thrombolysis in Cerebral Infarction 3-2b) was achieved in 23 patients (74%). A favorable outcome (mRS ≤ 2) was observed in 11 patients (35%). An optimal DWI brain stem score of |
| doi_str_mv | 10.3174/ajnr.A3870 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7965148</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1535627265</sourcerecordid><originalsourceid>FETCH-LOGICAL-c452t-8a0528a54e556ed4dff994e97029c2737c7e637c100b7d419dadeb5ad346cc4e3</originalsourceid><addsrcrecordid>eNqNkV9rFDEUxYModlt98QNIHkWYmkz-TXwQltqqUBD8A76FbHJnN2VmsiaZln6MfuNmt7XYt77c-3B-nHMvB6E3lBwzqvgHezGl4yXrFHmGFlQz2Wih_zxHC0K1aCQl3QE6zPmCECK0al-ig5aLluuWLNDN59D3cw5xaq4grDcFPA6jXYdpjbOLCXDscdkAXiUbJpwLjB_xEm8T-OBKTDs5zsXFEXDVrZtLZW0Og03YpgLpGkfnhn0ELgnsLuEqlM3e9WccQrGhxpz9wB4ug4NX6EVvhwyv7_cR-n12-uvka3P-_cu3k-V54-rxpeksEW1nBQchJHju-15rDlqRVrtWMeUUyDopISvlOdXeelgJ6xmXznFgR-jTne92Xo3gHUwl2cFsU30_XZtog3msTGFj1vHSKC0F5V01eHdvkOLfGXIxY8gOhsFOEOdsqBBUMq0kfQLKhGxVK0VF39-hLsWcE_QPF1FidnWbXd1mX3eF3_7_wwP6r192C0NZqbU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1535627265</pqid></control><display><type>article</type><title>Diffusion-weighted imaging score of the brain stem: A predictor of outcome in acute basilar artery occlusion treated with the Solitaire FR device</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Mourand, I ; Machi, P ; Nogué, E ; Arquizan, C ; Costalat, V ; Picot, M-C ; Bonafé, A ; Milhaud, D</creator><creatorcontrib>Mourand, I ; Machi, P ; Nogué, E ; Arquizan, C ; Costalat, V ; Picot, M-C ; Bonafé, A ; Milhaud, D</creatorcontrib><description>The prognosis for ischemic stroke due to acute basilar artery occlusion is very poor: Early recanalization remains the main factor that can improve outcomes. The baseline extent of brain stem ischemic damage can also influence outcomes. We evaluated the validity of an easy-to-use DWI score to predict clinical outcome in patients with acute basilar artery occlusion treated by mechanical thrombectomy.
We analyzed the baseline clinical and DWI parameters of 31 patients with acute basilar artery occlusion, treated within 24 hours of symptom onset by using a Solitaire FR device. The DWI score of the brain stem was assessed with a 12-point semiquantitative score that separately considered each side of the medulla, pons, and midbrain. Clinical outcome was assessed at 180 days by using the mRS. According to receiver operating characteristic analyses, the cutoff score determined the optimal positive predictive value for outcome. The Spearman rank correlation coefficient assessed the correlation between the DWI brain stem score and baseline characteristics.
Successful recanalization (Thrombolysis in Cerebral Infarction 3-2b) was achieved in 23 patients (74%). A favorable outcome (mRS ≤ 2) was observed in 11 patients (35%). An optimal DWI brain stem score of <3 predicted a favorable outcome. The probability of a very poor outcome (mRS ≥ 5) if the DWI brain stem score was ≥5 reached 80% (positive predictive value) and 100% if this score was ≥6. Interobserver reliability of the DWI brain stem score was excellent, with an intraclass correlation coefficient of 0.97 (95% CI, 0.96-0.99). The DWI brain stem score was significantly associated with baseline tetraplegia (P = .001) and coma (P = .005).
In patients with acute basilar artery occlusion treated by mechanical thrombectomy, the baseline DWI brain lesion score seems to predict clinical outcome.</description><identifier>ISSN: 0195-6108</identifier><identifier>EISSN: 1936-959X</identifier><identifier>DOI: 10.3174/ajnr.A3870</identifier><identifier>PMID: 24524920</identifier><language>eng</language><publisher>United States: American Society of Neuroradiology</publisher><subject>Brain ; Brain Stem - pathology ; Diffusion Magnetic Resonance Imaging - methods ; Equipment Design ; Equipment Failure Analysis ; Female ; Humans ; Male ; Mechanical Thrombolysis - instrumentation ; Mechanical Thrombolysis - methods ; Middle Aged ; Prognosis ; Reproducibility of Results ; Sensitivity and Specificity ; Treatment Outcome ; Vertebrobasilar Insufficiency - pathology ; Vertebrobasilar Insufficiency - therapy</subject><ispartof>American journal of neuroradiology : AJNR, 2014-06, Vol.35 (6), p.1117-1123</ispartof><rights>2014 by American Journal of Neuroradiology.</rights><rights>2014 by American Journal of Neuroradiology 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c452t-8a0528a54e556ed4dff994e97029c2737c7e637c100b7d419dadeb5ad346cc4e3</citedby><cites>FETCH-LOGICAL-c452t-8a0528a54e556ed4dff994e97029c2737c7e637c100b7d419dadeb5ad346cc4e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7965148/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7965148/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24524920$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mourand, I</creatorcontrib><creatorcontrib>Machi, P</creatorcontrib><creatorcontrib>Nogué, E</creatorcontrib><creatorcontrib>Arquizan, C</creatorcontrib><creatorcontrib>Costalat, V</creatorcontrib><creatorcontrib>Picot, M-C</creatorcontrib><creatorcontrib>Bonafé, A</creatorcontrib><creatorcontrib>Milhaud, D</creatorcontrib><title>Diffusion-weighted imaging score of the brain stem: A predictor of outcome in acute basilar artery occlusion treated with the Solitaire FR device</title><title>American journal of neuroradiology : AJNR</title><addtitle>AJNR Am J Neuroradiol</addtitle><description>The prognosis for ischemic stroke due to acute basilar artery occlusion is very poor: Early recanalization remains the main factor that can improve outcomes. The baseline extent of brain stem ischemic damage can also influence outcomes. We evaluated the validity of an easy-to-use DWI score to predict clinical outcome in patients with acute basilar artery occlusion treated by mechanical thrombectomy.
We analyzed the baseline clinical and DWI parameters of 31 patients with acute basilar artery occlusion, treated within 24 hours of symptom onset by using a Solitaire FR device. The DWI score of the brain stem was assessed with a 12-point semiquantitative score that separately considered each side of the medulla, pons, and midbrain. Clinical outcome was assessed at 180 days by using the mRS. According to receiver operating characteristic analyses, the cutoff score determined the optimal positive predictive value for outcome. The Spearman rank correlation coefficient assessed the correlation between the DWI brain stem score and baseline characteristics.
Successful recanalization (Thrombolysis in Cerebral Infarction 3-2b) was achieved in 23 patients (74%). A favorable outcome (mRS ≤ 2) was observed in 11 patients (35%). An optimal DWI brain stem score of <3 predicted a favorable outcome. The probability of a very poor outcome (mRS ≥ 5) if the DWI brain stem score was ≥5 reached 80% (positive predictive value) and 100% if this score was ≥6. Interobserver reliability of the DWI brain stem score was excellent, with an intraclass correlation coefficient of 0.97 (95% CI, 0.96-0.99). The DWI brain stem score was significantly associated with baseline tetraplegia (P = .001) and coma (P = .005).
In patients with acute basilar artery occlusion treated by mechanical thrombectomy, the baseline DWI brain lesion score seems to predict clinical outcome.</description><subject>Brain</subject><subject>Brain Stem - pathology</subject><subject>Diffusion Magnetic Resonance Imaging - methods</subject><subject>Equipment Design</subject><subject>Equipment Failure Analysis</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Mechanical Thrombolysis - instrumentation</subject><subject>Mechanical Thrombolysis - methods</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Treatment Outcome</subject><subject>Vertebrobasilar Insufficiency - pathology</subject><subject>Vertebrobasilar Insufficiency - therapy</subject><issn>0195-6108</issn><issn>1936-959X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkV9rFDEUxYModlt98QNIHkWYmkz-TXwQltqqUBD8A76FbHJnN2VmsiaZln6MfuNmt7XYt77c-3B-nHMvB6E3lBwzqvgHezGl4yXrFHmGFlQz2Wih_zxHC0K1aCQl3QE6zPmCECK0al-ig5aLluuWLNDN59D3cw5xaq4grDcFPA6jXYdpjbOLCXDscdkAXiUbJpwLjB_xEm8T-OBKTDs5zsXFEXDVrZtLZW0Og03YpgLpGkfnhn0ELgnsLuEqlM3e9WccQrGhxpz9wB4ug4NX6EVvhwyv7_cR-n12-uvka3P-_cu3k-V54-rxpeksEW1nBQchJHju-15rDlqRVrtWMeUUyDopISvlOdXeelgJ6xmXznFgR-jTne92Xo3gHUwl2cFsU30_XZtog3msTGFj1vHSKC0F5V01eHdvkOLfGXIxY8gOhsFOEOdsqBBUMq0kfQLKhGxVK0VF39-hLsWcE_QPF1FidnWbXd1mX3eF3_7_wwP6r192C0NZqbU</recordid><startdate>20140601</startdate><enddate>20140601</enddate><creator>Mourand, I</creator><creator>Machi, P</creator><creator>Nogué, E</creator><creator>Arquizan, C</creator><creator>Costalat, V</creator><creator>Picot, M-C</creator><creator>Bonafé, A</creator><creator>Milhaud, D</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>7X8</scope><scope>7TK</scope><scope>5PM</scope></search><sort><creationdate>20140601</creationdate><title>Diffusion-weighted imaging score of the brain stem: A predictor of outcome in acute basilar artery occlusion treated with the Solitaire FR device</title><author>Mourand, I ; Machi, P ; Nogué, E ; Arquizan, C ; Costalat, V ; Picot, M-C ; Bonafé, A ; Milhaud, D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c452t-8a0528a54e556ed4dff994e97029c2737c7e637c100b7d419dadeb5ad346cc4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Brain</topic><topic>Brain Stem - pathology</topic><topic>Diffusion Magnetic Resonance Imaging - methods</topic><topic>Equipment Design</topic><topic>Equipment Failure Analysis</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Mechanical Thrombolysis - instrumentation</topic><topic>Mechanical Thrombolysis - methods</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Treatment Outcome</topic><topic>Vertebrobasilar Insufficiency - pathology</topic><topic>Vertebrobasilar Insufficiency - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mourand, I</creatorcontrib><creatorcontrib>Machi, P</creatorcontrib><creatorcontrib>Nogué, E</creatorcontrib><creatorcontrib>Arquizan, C</creatorcontrib><creatorcontrib>Costalat, V</creatorcontrib><creatorcontrib>Picot, M-C</creatorcontrib><creatorcontrib>Bonafé, A</creatorcontrib><creatorcontrib>Milhaud, D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</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>Mourand, I</au><au>Machi, P</au><au>Nogué, E</au><au>Arquizan, C</au><au>Costalat, V</au><au>Picot, M-C</au><au>Bonafé, A</au><au>Milhaud, D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diffusion-weighted imaging score of the brain stem: A predictor of outcome in acute basilar artery occlusion treated with the Solitaire FR device</atitle><jtitle>American journal of neuroradiology : AJNR</jtitle><addtitle>AJNR Am J Neuroradiol</addtitle><date>2014-06-01</date><risdate>2014</risdate><volume>35</volume><issue>6</issue><spage>1117</spage><epage>1123</epage><pages>1117-1123</pages><issn>0195-6108</issn><eissn>1936-959X</eissn><abstract>The prognosis for ischemic stroke due to acute basilar artery occlusion is very poor: Early recanalization remains the main factor that can improve outcomes. The baseline extent of brain stem ischemic damage can also influence outcomes. We evaluated the validity of an easy-to-use DWI score to predict clinical outcome in patients with acute basilar artery occlusion treated by mechanical thrombectomy.
We analyzed the baseline clinical and DWI parameters of 31 patients with acute basilar artery occlusion, treated within 24 hours of symptom onset by using a Solitaire FR device. The DWI score of the brain stem was assessed with a 12-point semiquantitative score that separately considered each side of the medulla, pons, and midbrain. Clinical outcome was assessed at 180 days by using the mRS. According to receiver operating characteristic analyses, the cutoff score determined the optimal positive predictive value for outcome. The Spearman rank correlation coefficient assessed the correlation between the DWI brain stem score and baseline characteristics.
Successful recanalization (Thrombolysis in Cerebral Infarction 3-2b) was achieved in 23 patients (74%). A favorable outcome (mRS ≤ 2) was observed in 11 patients (35%). An optimal DWI brain stem score of <3 predicted a favorable outcome. The probability of a very poor outcome (mRS ≥ 5) if the DWI brain stem score was ≥5 reached 80% (positive predictive value) and 100% if this score was ≥6. Interobserver reliability of the DWI brain stem score was excellent, with an intraclass correlation coefficient of 0.97 (95% CI, 0.96-0.99). The DWI brain stem score was significantly associated with baseline tetraplegia (P = .001) and coma (P = .005).
In patients with acute basilar artery occlusion treated by mechanical thrombectomy, the baseline DWI brain lesion score seems to predict clinical outcome.</abstract><cop>United States</cop><pub>American Society of Neuroradiology</pub><pmid>24524920</pmid><doi>10.3174/ajnr.A3870</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0195-6108 |
| ispartof | American journal of neuroradiology : AJNR, 2014-06, Vol.35 (6), p.1117-1123 |
| issn | 0195-6108 1936-959X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7965148 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Brain Brain Stem - pathology Diffusion Magnetic Resonance Imaging - methods Equipment Design Equipment Failure Analysis Female Humans Male Mechanical Thrombolysis - instrumentation Mechanical Thrombolysis - methods Middle Aged Prognosis Reproducibility of Results Sensitivity and Specificity Treatment Outcome Vertebrobasilar Insufficiency - pathology Vertebrobasilar Insufficiency - therapy |
| title | Diffusion-weighted imaging score of the brain stem: A predictor of outcome in acute basilar artery occlusion treated with the Solitaire FR device |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-30T05%3A31%3A38IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Diffusion-weighted%20imaging%20score%20of%20the%20brain%20stem:%20A%20predictor%20of%20outcome%20in%20acute%20basilar%20artery%20occlusion%20treated%20with%20the%20Solitaire%20FR%20device&rft.jtitle=American%20journal%20of%20neuroradiology%20:%20AJNR&rft.au=Mourand,%20I&rft.date=2014-06-01&rft.volume=35&rft.issue=6&rft.spage=1117&rft.epage=1123&rft.pages=1117-1123&rft.issn=0195-6108&rft.eissn=1936-959X&rft_id=info:doi/10.3174/ajnr.A3870&rft_dat=%3Cproquest_pubme%3E1535627265%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1535627265&rft_id=info:pmid/24524920&rfr_iscdi=true |