Predictors of Infarct Growth Measured by ADC Quantification in Patients with Acute Ischemic Stroke.

Predictors of Infarct Growth Measured by ADC Quantification in Patients with Acute Ischemic Stroke.

World Neurosurg. 2018 Dec 24;:

Authors: Deng W, Teng J, Liebeskind D, Miao W, Du R

Abstract
BACKGROUND: and Purpose: Infarct volume is associated with clinical outcome after ischemic stroke. We investigated factors associated with infarct growth and its impact on functional outcome in patients with acute ischemic stroke.
MATERIALS AND METHODS: This retrospective study included 158 patients with acute ischemic stroke under endovascular treatment at University of California Los Angeles Medical Center between 2011 to 2016. Patients' clinical parameters were collected. MRI was performed pretreatment and 24 hours after endovascular treatment to calculate infarct volume. Infarct sizes were measured using ADC maps. mRS at discharge and at 90 days were used to evaluate functional outcome. mRS 0-2 was defined as a good outcome. Predictors of infarct growth and mRS at 90 days were analyzed by regression analysis.
RESULTS: Patients with smaller infarct growth had significantly better clinical outcomes as measured by mRS score at discharge, mRS score at 90 days, and mortality at 90 days (P<.001). Infarct growth of 12.11 cm2 was defined as the optimal cut-off value to predict clinical outcome according to the receiver operating characteristic curve. Baseline ASPECTS (OR 0.8, 95% CI: 0.665-0.962; P=.017) and modified TICI score (OR 0.259; 95% CI: 0.120-0.559; P=.001) were independent factors that predicted infarct growth. Infarct growth (OR 1.044; 95% CI: 1.024-1.064; P<.001) and baseline NIHSS (OR 1.070; 95% CI: 1.008-1.136; P=.027) were independent factors that predicted mRS at 90 days.
CONCLUSIONS: Infarct growth was associated with functional outcome. Smaller infarct growth correlated with better outcome. Higher ASPECTS and better perfusion predicted smaller infarct growth.

PMID: 30590217 [PubMed - as supplied by publisher]

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