RT Journal Article
SR Electronic
T1 Intracranial Artery Stenosis or Occlusion Predicts Ischemic Recurrence after Transient Ischemic Attack
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 185
OP 190
DO 10.3174/ajnr.A3144
VO 34
IS 1
A1 G. Ssi-Yan-Kai
A1 N. Nasr
A1 A. Faury
A1 I. Catalaa
A1 C. Cognard
A1 V. Larrue
A1 F. Bonneville
YR 2013
UL http://www.ajnr.org/content/34/1/185.abstract
AB BACKGROUND AND PURPOSE: Patterns of DWI findings that predict recurrent ischemic events after TIA are well-established, but similar assessments of intracranial MRA findings are not available. We sought to determine the imaging characteristics of MRA that are predictive of early recurrent stroke/TIA in patients with TIA. MATERIALS AND METHODS: We performed a retrospective analysis of 129 consecutive patients with a clinical diagnosis of TIA in whom MR imaging was done within 24 hours of symptom onset. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of >50% stenosis or occlusion of symptomatic intracranial arteries for recurrent stroke/TIA at 7 days after TIA. We used logistic regression analysis to adjust for the clinical ABCD2 score. We performed this analysis for symptomatic steno-occlusive lesions at any site and symptomatic steno-occlusive lesions on proximal large intracranial arteries (internal carotid artery, vertebral artery, basilar artery, and circle of Willis). RESULTS: Forty-two (32.5%) patients had acute ischemic lesions on DWI; 16 (12.4%) had significant MRA lesions, of which 11 (8.5%) were on proximal vessels. Nine patients had early recurrence (TIA, 7; minor stroke, 2). Only patients with proximal MRA lesions were at higher risk of early recurrence independent of the ABCD2 score (adjusted odds ratio, 5.5; 95% confidence interval, 1.1–27.8; P = .04). CONCLUSIONS: Proximal lesions of cerebral arteries seen on MRA were predictive of recurrent stroke/TIA at 7 days. These findings suggest that MRA could be used to improve the selection of patients with TIA at high risk of early recurrent stroke/TIA. ABCD2age, blood pressure, clinical deficit, duration, diabetesEKGelectrocardiogramMIPmaximum intensity projectionTOFtime of flight