Final cerebral infarct volume is predictable by MR imaging at 1 week.
AJNR Am J Neuroradiol. 2010-10-21; 32(2): 352-358
DOI: 10.3174/ajnr.a2271
Read on PubMed
1. AJNR Am J Neuroradiol. 2011 Feb;32(2):352-8. doi: 10.3174/ajnr.A2271. Epub 2010
Oct 21.
Final cerebral infarct volume is predictable by MR imaging at 1 week.
Tourdias T(1), Renou P, Sibon I, Asselineau J, Bracoud L, Dumoulin M, Rouanet F,
Orgogozo JM, Dousset V.
Author information:
(1)Service de NeuroImagerie Diagnostique et Thérapeutique, Université Victor
Segalen Bordeaux, CHU de Bordeaux, France.
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
(R(2) = 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.
DOI: 10.3174/ajnr.A2271
PMID: 20966063 [Indexed for MEDLINE]