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Thrombus magnetic susceptibility is associated with recanalization and clinical outcome in patients with ischemic stroke

In acute ischemic stroke patients with large vessel occlusion, the characteristics of the occluding thrombus on neuroimaging may be associated with recanalization after endovascular thrombectomy (EVT); however, the relationship between magnetic susceptibility of thrombus and clinical outcome remains...

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Autores principales: Chen, Jie, Zhang, Zhe, Nie, Ximing, Xu, Yuyuan, Liu, Chunlei, Zhao, Xingquan, Miao, Zhongrong, Wang, Yongjun, Liu, Liping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9472059/
https://www.ncbi.nlm.nih.gov/pubmed/36095890
http://dx.doi.org/10.1016/j.nicl.2022.103183
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author Chen, Jie
Zhang, Zhe
Nie, Ximing
Xu, Yuyuan
Liu, Chunlei
Zhao, Xingquan
Miao, Zhongrong
Wang, Yongjun
Liu, Liping
author_facet Chen, Jie
Zhang, Zhe
Nie, Ximing
Xu, Yuyuan
Liu, Chunlei
Zhao, Xingquan
Miao, Zhongrong
Wang, Yongjun
Liu, Liping
author_sort Chen, Jie
collection PubMed
description In acute ischemic stroke patients with large vessel occlusion, the characteristics of the occluding thrombus on neuroimaging may be associated with recanalization after endovascular thrombectomy (EVT); however, the relationship between magnetic susceptibility of thrombus and clinical outcome remains unclear. We utilized quantitative susceptibility mapping (QSM) MRI to assess the magnetic susceptibility of thrombus in acute ischemic stroke patients undergoing EVT, and to evaluate its relationship with recanalization and functional outcomes. Patients with documented intracranial artery occlusion were consecutively recruited from one research center of the RESCUE-RE study (a registration study for Critical Care of Acute Ischemic Stroke After Recanalization). All the recruited patients underwent a 3D multi-echo MRI scan on a 3.0 T scanner for both susceptibility-weighted imaging (SWI) and QSM quantification of the thrombus. Among 61 patients included in the analyses, 51 (75.0 %) patients achieved thrombolysis in cerebral infarction (TICI) 2b/3 and 22 (36.1 %) patients had favorable functional outcomes. Successful recanalization was significantly associated with a higher thrombus magnetic susceptibility mean value (0.27 ± 0.09 vs 0.20 ± 0.09 ppm, p = 0.020) and lower coefficient of variation (0.42 ± 0.12 vs 0.52 ± 0.19, p = 0.024). ROC curve analysis showed the optimal cutoff value for thrombus susceptibility for predicting good clinical outcomes was 0.25 ppm (sensitivity 86.4 %, specificity 69.2 %). In multivariable logistic regression analyses, increased thrombus magnetic susceptibility was independently and significantly associated with good functional outcomes (adjusted odds ratio 15.11 [95 % confidence interval 2.64–86.46], p = 0.002). This study demonstrated that the increased thrombus magnetic susceptibility is associated with successful recanalization and favorable functional outcomes for intracranial artery occluded stroke patients.
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spelling pubmed-94720592022-09-15 Thrombus magnetic susceptibility is associated with recanalization and clinical outcome in patients with ischemic stroke Chen, Jie Zhang, Zhe Nie, Ximing Xu, Yuyuan Liu, Chunlei Zhao, Xingquan Miao, Zhongrong Wang, Yongjun Liu, Liping Neuroimage Clin Regular Article In acute ischemic stroke patients with large vessel occlusion, the characteristics of the occluding thrombus on neuroimaging may be associated with recanalization after endovascular thrombectomy (EVT); however, the relationship between magnetic susceptibility of thrombus and clinical outcome remains unclear. We utilized quantitative susceptibility mapping (QSM) MRI to assess the magnetic susceptibility of thrombus in acute ischemic stroke patients undergoing EVT, and to evaluate its relationship with recanalization and functional outcomes. Patients with documented intracranial artery occlusion were consecutively recruited from one research center of the RESCUE-RE study (a registration study for Critical Care of Acute Ischemic Stroke After Recanalization). All the recruited patients underwent a 3D multi-echo MRI scan on a 3.0 T scanner for both susceptibility-weighted imaging (SWI) and QSM quantification of the thrombus. Among 61 patients included in the analyses, 51 (75.0 %) patients achieved thrombolysis in cerebral infarction (TICI) 2b/3 and 22 (36.1 %) patients had favorable functional outcomes. Successful recanalization was significantly associated with a higher thrombus magnetic susceptibility mean value (0.27 ± 0.09 vs 0.20 ± 0.09 ppm, p = 0.020) and lower coefficient of variation (0.42 ± 0.12 vs 0.52 ± 0.19, p = 0.024). ROC curve analysis showed the optimal cutoff value for thrombus susceptibility for predicting good clinical outcomes was 0.25 ppm (sensitivity 86.4 %, specificity 69.2 %). In multivariable logistic regression analyses, increased thrombus magnetic susceptibility was independently and significantly associated with good functional outcomes (adjusted odds ratio 15.11 [95 % confidence interval 2.64–86.46], p = 0.002). This study demonstrated that the increased thrombus magnetic susceptibility is associated with successful recanalization and favorable functional outcomes for intracranial artery occluded stroke patients. Elsevier 2022-09-06 /pmc/articles/PMC9472059/ /pubmed/36095890 http://dx.doi.org/10.1016/j.nicl.2022.103183 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Regular Article
Chen, Jie
Zhang, Zhe
Nie, Ximing
Xu, Yuyuan
Liu, Chunlei
Zhao, Xingquan
Miao, Zhongrong
Wang, Yongjun
Liu, Liping
Thrombus magnetic susceptibility is associated with recanalization and clinical outcome in patients with ischemic stroke
title Thrombus magnetic susceptibility is associated with recanalization and clinical outcome in patients with ischemic stroke
title_full Thrombus magnetic susceptibility is associated with recanalization and clinical outcome in patients with ischemic stroke
title_fullStr Thrombus magnetic susceptibility is associated with recanalization and clinical outcome in patients with ischemic stroke
title_full_unstemmed Thrombus magnetic susceptibility is associated with recanalization and clinical outcome in patients with ischemic stroke
title_short Thrombus magnetic susceptibility is associated with recanalization and clinical outcome in patients with ischemic stroke
title_sort thrombus magnetic susceptibility is associated with recanalization and clinical outcome in patients with ischemic stroke
topic Regular Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9472059/
https://www.ncbi.nlm.nih.gov/pubmed/36095890
http://dx.doi.org/10.1016/j.nicl.2022.103183
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