Diffusion-weighted imaging as predictor of acute ischemic stroke etiology
Journal
Arquivos de Neuro-Psiquiatria
ISSN
1678-4227
0004-282X
Date Issued
2022
Author(s)
Alejandro Michel Brunser
Alexis Rojo
Type
Resource Types::text::journal::journal article
URL Institutional Repository
Abstract
<jats:p>Abstract Background: Topographic patterns may correlate with causes of ischemic stroke. Objective: To investigate the association between diffusion-weighted imaging (DWI) and Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Methods: We included 1019 ischemic stroke patients. DWI were classified as: i) negative; ii) DWI single lesion (cortico-subcortical, cortical, subcortical ≥20 mm, or subcortical <20 mm); iii) scattered lesions in one territory (small scattered lesions or confluent with additional lesions); and iv) multiple lesions (multiple unilateral anterior circulation [MAC], multiple posterior circulation [MPC], multiple bilateral anterior circulation [MBAC], and multiple anterior and posterior circulations [MAP]). Results: There was a relationship between DWI patterns and TOAST classification (p<0.001). Large artery atherosclerosis was associated with small, scattered lesions in one vascular territory (Odds Ratio [OR] 4.22, 95% confidence interval [95%CI] 2.61–6.8), MPC (OR 3.52; 95%CI 1.54–8.03), and subcortical lesions <20 mm (OR 3.47; 95%CI 1.76–6.85). Cardioembolic strokes correlated with MAP (OR 4.3; 95%CI 1.64–11.2), cortico-subcortical lesions (OR 3.24; 95%CI 1.9–5.5) and negative DWI (OR 2.46; 95%CI 1.1–5.49). Cryptogenic strokes correlated with negative DWI (OR 4.1; 95%CI 1,84–8.69), cortical strokes (OR 3.3; 95%CI 1.25–8.8), MAP (OR 3.33; 95%CI 1.25–8.81) and subcortical lesion ≥20 mm (OR 2.44; 95%CI 1,04–5.73). Lacunar strokes correlated with subcortical lesions diameter <20 mm (OR 42.9; 95%CI 22.7–81.1) and negative DWI (OR 8.87; 95%CI 4.03–19.5). Finally, MBAC (OR 9.25; 95%CI 1.12–76.2), MAP (OR 5.54; 95%CI 1.94–15.1), and MPC (OR 3.61; 95%CI 1.5–8.7) correlated with stroke of other etiologies. Conclusions: A relationship exists between DWI and stroke subtype.</jats:p>
Cite this document
Brunser, A. M., Mansilla, E., Navia, V., Mazzon, E., Rojo, A., Cavada, G., Olavarría, V., Venturelli, P. M., & Lavados, P. Manuel. (2022). Diffusion-weighted imaging as predictor of acute ischemic stroke etiology. Arquivos de Neuro-Psiquiatria, 80(4), 353-359. https://doi.org/10.1590/0004-282x-anp-2021-0080
Subjects
stroke
;
lschemic stroke
;
diffusion magnetic resonance imaging
;
diagnosis
;
atherosclerosis
;
diffusion magnetic resonance imaging
;
humans
;
ischemic stroke
;
stroke
;
acute ischemic stroke
;
aged
;
article
;
atherosclerosis
;
brain cortex lesion
;
cardioembolic stroke
;
cerebrovascular accident
;
computed tomographic angiography
;
computer assisted tomography
;
controlled study
;
diffusion weighted imaging
;
female
;
follow up
;
human
;
lacunar stroke
;
magnetic resonance angiography
;
major clinical study
;
male
;
national institutes of health stroke scale
;
nuclear magnetic resonance imaging
;
prediction
;
prospective study
;
stroke patient
;
telemetry
;
transthoracic echocardiography
;
atherosclerosis
;
brain ischemia
;
cerebrovascular accident
;
diagnostic imaging
;
diffusion weighted imaging
;
pathology