RT Journal Article
SR Electronic
T1 Final Cerebral Infarct Volume Is Predictable by MR Imaging at 1 Week
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 352
OP 358
DO 10.3174/ajnr.A2271
VO 32
IS 2
A1 T. Tourdias
A1 P. Renou
A1 I. Sibon
A1 J. Asselineau
A1 L. Bracoud
A1 M. Dumoulin
A1 F. Rouanet
A1 J.M. Orgogozo
A1 V. Dousset
YR 2011
UL http://www.ajnr.org/content/32/2/352.abstract
AB BACKGROUND AND PURPOSE: Stroke volume, an increasingly used end point in phase II trials, is considered stationary at least 30 days after the ictus. We investigated whether information conveyed by MR imaging measurements of the “final” infarct volume could be assessed as early as the subacute stage (days 3–6), rather than waiting for the chronic stage (days 30–45). MATERIALS AND METHODS: Ninety-five patients with middle cerebral artery stroke prospectively included in a multicenter study underwent MR imaging during the first 12 hours (MR imaging-1), between days 3 and 6 (MR imaging-2), and between days 30 and 45 (MR imaging-3). We first investigated the relationship between subacute (FLAIR-2) and chronic volumes (FLAIR-3), by using a linear regression model. We then tested the relationship between FLAIR volumes (either FLAIR-2 or FLAIR-3) and functional disability, measured by the mRS at the time of MR imaging-3, by using logistic regression. The performances of the models were assessed by using the AUC in ROC. RESULTS: A linear association between log FLAIR-2 and log FLAIR-3 volumes was observed. The proportion of FLAIR-3 variation, explained by FLAIR-2, was high (R2 = 81%), without a covariate that improved this percentage. Both FLAIR-2 and FLAIR-3 were independent predictors of mRS (OR, 0.79 and 0.73; 95% CI, 0.64–0.97 and 0.56–0.96; P = .026 and .023). The performances of the models for the association between either FLAIR volume and mRS did not differ (AUC = 0.897 for FLAIR-2 and 0.888 for FLAIR-3). CONCLUSIONS: Stroke damage may be assessed by a subacute volume because subacute volume predicts the “true” final volume and provides the same clinical prognosis. ADCapparent diffusion coefficientAUCarea under the curveBIBarthel indexCIconfidence intervalDWIdiffusion-weighted imagingECASSEuropean Cooperative Acute Stroke StudyEPITHETEcho-Planar Imaging Thrombolytic Evaluation TrialFLAIRfluid-attenuated inversion recoveryICAinternal carotid arteryloglogarithmicMRAMR angiographymRSmodified Rankin Scale, NIHSS =National Institutes of Health Stroke Scale; ORodds ratioPHparenchymal hematomaPWIperfusion-weighted imagingQ1-Q3first and third quartile of interquartile rangeROCreceiver operating characteristic analysisTPtime pointTTPtime-to-peakVIRAGEValeur predictive des paramètres IRM à la phase aigue de l'Accident vasculaire cerebral: application à la Gestion des Essais thérapeutiques