Multimodal CT Imaging Characteristics in Predicting Prognosis of Wake-Up Stroke

Background: Multimodal CT imaging can evaluate cerebral hemodynamics and stroke etiology, playing an important role in predicting prognosis. This study aimed to summarize the comprehensive image characteristics of wake-up stroke (WUS), and to explore its value in prognostication.Methods: WUS patient...

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Autores principales:	Fan Yu, Xuesong Bai, Arman Sha, Miao Zhang, Yi Shan, Daode Guo, Adam A. Dmytriw, Qingfeng Ma, Liqun Jiao, Jie Lu
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	wake-up stroke ischemic penumbra collateral circulation prognostic value CT perfusion (CTP) Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/dae56408546a461fa12a5cb66272c3f9
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spelling	oai:doaj.org-article:dae56408546a461fa12a5cb66272c3f92021-11-15T06:46:58ZMultimodal CT Imaging Characteristics in Predicting Prognosis of Wake-Up Stroke1664-229510.3389/fneur.2021.702088https://doaj.org/article/dae56408546a461fa12a5cb66272c3f92021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.702088/fullhttps://doaj.org/toc/1664-2295Background: Multimodal CT imaging can evaluate cerebral hemodynamics and stroke etiology, playing an important role in predicting prognosis. This study aimed to summarize the comprehensive image characteristics of wake-up stroke (WUS), and to explore its value in prognostication.Methods: WUS patients with anterior circulation large vessel occlusion were recruited into this prospective study. According to the 90-day modified Rankin Scale (mRS), all patients were divided into good outcome (mRS 0–2) or bad (mRS 3–6). Baseline clinical information, multimodal CT imaging characteristics including NECT ASPECTS, clot burden score (CBS), collateral score, volume of penumbra and ischemic core on perfusion were compared. Multivariate logistic regression analysis was further used to analyze predictive factors for good prognosis. Area under curve (AUC) was calculated from the receiver operating characteristic (ROC) curve to assess prognostic value.Results: Forty WUS were analyzed in this study, with 20 (50%) achieving good outcome. Upon univariable analysis, the good outcome group demonstrated higher ASPECTS, higher CBS, higher rate of good collateral filling and lower penumbra volume when compared with the poor outcome group. Upon logistic regression analysis, poor outcome significantly correlated with penumbra volume (OR: 1.023, 95% CI = 1.003–1.043) and collateral score (OR: 0.140, 95% CI = 0.030–0.664). AUC was 0.715 for penumbra volume (95% CI, 0.550–0.846) and 0.825 for good collaterals (95% CI, 0.672–0.927) in predicting outcome.Conclusions:Penumbra volume and collateral score are the most relevant baseline imaging characters in predicting outcome of WUS patients. These imaging characteristics might be instructive to treatment selection. As the small sample size of current study, further studies with larger sample size are needed to confirm these observations.Fan YuFan YuXuesong BaiXuesong BaiArman ShaArman ShaMiao ZhangMiao ZhangYi ShanYi ShanDaode GuoDaode GuoAdam A. DmytriwQingfeng MaLiqun JiaoLiqun JiaoLiqun JiaoJie LuJie LuFrontiers Media S.A.articlewake-up strokeischemic penumbracollateral circulationprognostic valueCT perfusion (CTP)Neurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	wake-up stroke ischemic penumbra collateral circulation prognostic value CT perfusion (CTP) Neurology. Diseases of the nervous system RC346-429
spellingShingle	wake-up stroke ischemic penumbra collateral circulation prognostic value CT perfusion (CTP) Neurology. Diseases of the nervous system RC346-429 Fan Yu Fan Yu Xuesong Bai Xuesong Bai Arman Sha Arman Sha Miao Zhang Miao Zhang Yi Shan Yi Shan Daode Guo Daode Guo Adam A. Dmytriw Qingfeng Ma Liqun Jiao Liqun Jiao Liqun Jiao Jie Lu Jie Lu Multimodal CT Imaging Characteristics in Predicting Prognosis of Wake-Up Stroke
description	Background: Multimodal CT imaging can evaluate cerebral hemodynamics and stroke etiology, playing an important role in predicting prognosis. This study aimed to summarize the comprehensive image characteristics of wake-up stroke (WUS), and to explore its value in prognostication.Methods: WUS patients with anterior circulation large vessel occlusion were recruited into this prospective study. According to the 90-day modified Rankin Scale (mRS), all patients were divided into good outcome (mRS 0–2) or bad (mRS 3–6). Baseline clinical information, multimodal CT imaging characteristics including NECT ASPECTS, clot burden score (CBS), collateral score, volume of penumbra and ischemic core on perfusion were compared. Multivariate logistic regression analysis was further used to analyze predictive factors for good prognosis. Area under curve (AUC) was calculated from the receiver operating characteristic (ROC) curve to assess prognostic value.Results: Forty WUS were analyzed in this study, with 20 (50%) achieving good outcome. Upon univariable analysis, the good outcome group demonstrated higher ASPECTS, higher CBS, higher rate of good collateral filling and lower penumbra volume when compared with the poor outcome group. Upon logistic regression analysis, poor outcome significantly correlated with penumbra volume (OR: 1.023, 95% CI = 1.003–1.043) and collateral score (OR: 0.140, 95% CI = 0.030–0.664). AUC was 0.715 for penumbra volume (95% CI, 0.550–0.846) and 0.825 for good collaterals (95% CI, 0.672–0.927) in predicting outcome.Conclusions:Penumbra volume and collateral score are the most relevant baseline imaging characters in predicting outcome of WUS patients. These imaging characteristics might be instructive to treatment selection. As the small sample size of current study, further studies with larger sample size are needed to confirm these observations.
format	article
author	Fan Yu Fan Yu Xuesong Bai Xuesong Bai Arman Sha Arman Sha Miao Zhang Miao Zhang Yi Shan Yi Shan Daode Guo Daode Guo Adam A. Dmytriw Qingfeng Ma Liqun Jiao Liqun Jiao Liqun Jiao Jie Lu Jie Lu
author_facet	Fan Yu Fan Yu Xuesong Bai Xuesong Bai Arman Sha Arman Sha Miao Zhang Miao Zhang Yi Shan Yi Shan Daode Guo Daode Guo Adam A. Dmytriw Qingfeng Ma Liqun Jiao Liqun Jiao Liqun Jiao Jie Lu Jie Lu
author_sort	Fan Yu
title	Multimodal CT Imaging Characteristics in Predicting Prognosis of Wake-Up Stroke
title_short	Multimodal CT Imaging Characteristics in Predicting Prognosis of Wake-Up Stroke
title_full	Multimodal CT Imaging Characteristics in Predicting Prognosis of Wake-Up Stroke
title_fullStr	Multimodal CT Imaging Characteristics in Predicting Prognosis of Wake-Up Stroke
title_full_unstemmed	Multimodal CT Imaging Characteristics in Predicting Prognosis of Wake-Up Stroke
title_sort	multimodal ct imaging characteristics in predicting prognosis of wake-up stroke
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/dae56408546a461fa12a5cb66272c3f9
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Multimodal CT Imaging Characteristics in Predicting Prognosis of Wake-Up Stroke

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