Parenchymal FLAIR hyperintensity before thrombolysis is a prognostic factor of ischemic stroke outcome at 3 Tesla - 13/08/15
, Sébastien Soize, Laurence Riffaud, Olivier Toubas, Francis Pombourcq, Laurent PierotBienvenue sur EM-consulte, la référence des professionnels de santé.
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Summary |
Background |
The goal of the present study was to determine whether the presence or absence of parenchymal FLAIR hyperintensity alone, before thrombolysis, might be a predictive factor of ischemic stroke outcomes after the acute phase of stroke and at 3 months.
Materials and methods |
We retrospectively included 84 patients with an ischemic stroke between November 2007 and March 2012, who underwent 3T MRI, were treated by thrombolysis, and had medical follow-up at 3 months. Two readers analyzed parenchymal FLAIR visibility. Logistic regressions were performed for NIHSS difference (NIHSS at admission – NIHSS at the end of hospitalization) and for 3 months modified Ranking Score (mRS). Predictive values of positive parenchymal FLAIR for identifying poor outcome at discharge and at 3 months were estimated.
Results |
Parenchymal FLAIR positivity was not predictive of NIHSS difference but it predicted poor outcome at 3 months (sensitivity: 0.49 [0.37–0.60], specificity: 0.69 [0.46–0.91], positive predictive value: 0.87 [0.76–0.98] and negative predictive value: 0.24 [0.12–0.36]).
Conclusions |
At 3 Tesla, the presence of a parenchymal hyperintense FLAIR signal before thrombolysis is predictive of a poor clinical outcome at 3 months.
Le texte complet de cet article est disponible en PDF.Keywords : Acute stroke, Prognosis, Magnetic resonance imaging, Therapeutic thrombolysis, Assessments, Patient outcomes
Abbreviations : FLAIR, iv-tPA, MCA, DWI, NIHSS, mRS, DWI-ASPECTS, Se, Sp, PPV, NPV
Plan
Vol 42 - N° 5
P. 269-277 - octobre 2015 Retour au numéro
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