Diffusion-weighted imaging (DWI) ischemic volume is related to FLAIR hyperintensity-DWI mismatch and functional outcome after endovascular therapy

摘要

Background: We assessed whether diffusion-weighted imaging (DWI) volume was associated with fluid- attenuated inversion recovery vascular hyperintensities (FVH)-DWI mismatch and functional outcome in patients with acute stroke who received endovascular therapy (EVT). Methods: Fifty-three acute stroke patients who received EVT were enrolled. FVH-DWI mismatch, DWI volume on admission, DWI volume on follow-up, DWI volume growth, the functional outcome at 3 months (mRS) and other clinical data were collected. Receiver operating characteristic (ROC) analysis was performed to evaluate the value of DWI volume in predicting functional outcome after stroke. Results: The FVH-DWI mismatch group had a smaller DWI volume on admission (13.86±19.58 vs . 65.07±52.21; t=?4.301, P=0.000), a smaller DWI volume on follow-up (29.88±33.52 vs . 112.43±87.19; t=?4.143, P=0.000), and a lower DWI volume growth (16.02±19.90 vs . 47.36±40.06; t=?3.326, P=0.003) than those of the no FVH-DWI mismatch group. The good functional outcome group had a smaller DWI volume on admission (13.30±13.26 vs . 68.56±54.28; t=?5.611, P=0.000), a smaller DWI volume on follow-up (27.65±18.80 vs . 120.25±90.37; t=?5.720, P=0.000), lower DWI volume growth (14.35±15.06 vs . 51.69±41.17; t=?4.737, P=0.001) and a higher FVH-DWI mismatch ratio (75.76% vs . 35%; t=8.647; P=0.004) than those of the poor functional outcome group. ROC analysis showed that the sensitivity and specificity of DWI volume on admission for predicting functional outcome were 65% and 96.97%, respectively (the optimal cut-off value: 33.50 mL); DWI volume on follow-up was 48.6 mL, with a sensitivity and specificity of 80% and 87.88%, respectively; DWI volume growth was 22.25 mL, with a sensitivity and specificity of 70% and 87.88%, respectively. Conclusions: DWI volume and DWI volume growth can provide the prognostic information of acute stroke patients after thrombectomy.