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@article{1786837,
author = {Ospel, J. M. and Menon, B.K. and Qiu, W. and Kashani, N. and Mayank, A. and Singh, N. and Cimflová, Petra and Marko, M. and Nogueira, R. G. and McTaggart, R. A. and Demchuk, A. M. and Poppe, A. Y. and Zerna, C. and Joshi, M. and Almekhlafi, M. A. and Haussen, D. and Cutting, S. and Coutts, S. B.. and Roy, D. and Rohr, A. and Iancu, D. and Tymianski, M. and Hill, M. D. and Goyal, M.},
article_location = {Chicago},
article_number = {1},
doi = {http://dx.doi.org/10.1148/radiol.2021203964},
keywords = {Infarct Patterns and Volumes; 24-hour Noncontrast CT; Diffusion-weighted MRI; cute Ischemic Stroke; Large Vessel Occlusion},
language = {eng},
issn = {0033-8419},
journal = {Radiology},
title = {A Detailed Analysis of Infarct Patterns and Volumes at 24-hour Noncontrast CT and Diffusion-weighted MRI in Acute Ischemic Stroke Due to Large Vessel Occlusion: Results from the ESCAPE-NA1 Trial},
url = {https://pubs.rsna.org/doi/10.1148/radiol.2021203964},
volume = {300},
year = {2021}
}
TY - JOUR
ID - 1786837
AU - Ospel, J. M. - Menon, B.K. - Qiu, W. - Kashani, N. - Mayank, A. - Singh, N. - Cimflová, Petra - Marko, M. - Nogueira, R. G. - McTaggart, R. A. - Demchuk, A. M. - Poppe, A. Y. - Zerna, C. - Joshi, M. - Almekhlafi, M. A. - Haussen, D. - Cutting, S. - Coutts, S. B.. - Roy, D. - Rohr, A. - Iancu, D. - Tymianski, M. - Hill, M. D. - Goyal, M.
PY - 2021
TI - A Detailed Analysis of Infarct Patterns and Volumes at 24-hour Noncontrast CT and Diffusion-weighted MRI in Acute Ischemic Stroke Due to Large Vessel Occlusion: Results from the ESCAPE-NA1 Trial
JF - Radiology
VL - 300
IS - 1
SP - 152-159
EP - 152-159
PB - The Radiological Society of North America
SN - 00338419
KW - Infarct Patterns and Volumes
KW - 24-hour Noncontrast CT
KW - Diffusion-weighted MRI
KW - cute Ischemic Stroke
KW - Large Vessel Occlusion
UR - https://pubs.rsna.org/doi/10.1148/radiol.2021203964
N2 - Background: The effect of infarct pattern on functional outcome in acute ischemic stroke is incompletely understood. Purpose: To investigate the association of qualitative and quantitative infarct variables at 24-hour follow-up noncontrast CT and diffusion-weighted MRI with 90-day clinical outcome. Materials and Methods: The Safety and Efficacy of Nerinetide in Subjects Undergoing Endovascular Thrombectomy for Stroke, or ESCAPE-NA1, randomized controlled trial enrolled patients with large-vessel-occlusion stroke undergoing mechanical thrombectomy from March 1, 2017, to August 12, 2019. In this post hoc analysis of the trial, qualitative infarct variables (predominantly gray [vs gray and white] matter involvement, corticospinal tract involvement, infarct structure [scattered vs territorial]) and total infarct volume were assessed at 24-hour follow-up noncontrast CT or diffusion-weighted MRI. White and gray matter infarct volumes were assessed in patients by using follow-up diffusion-weighted MRI. Infarct variables were compared between patients with and those without good outcome, defined as a modified Rankin Scale score of 0-2 at 90 days. The association of infarct variables with good outcome was determined with use of multivariable logistic regression. Separate regression models were used to report effect size estimates with adjustment for total infarct volume. Results: Qualitative infarct variables were assessed in 1026 patients (mean age +/- standard deviation, 69 years +/- 13; 522 men) and quantitative infarct variables were assessed in a subgroup of 358 of 1026 patients (mean age, 67 years +/- 13; 190 women). Patients with gray and white matter involvement (odds ratio [OR] after multivariable adjustment, 0.19; 95% CI: 0.14, 0.25; P < .001), corticospinal tract involvement (OR after multivariable adjustment, 0.06; 95% CI: 0.04, 0.10; P < .001), and territorial infarcts (OR after multivariable adjustment, 0.22; 95% CI: 0.14, 0.32; P < .001) were less likely to achieve good outcome, independent of total infarct volume. Conclusion: Infarct confinement to the gray matter, corticospinal tract sparing, and scattered infarct structure at 24-hour noncontrast CT and diffusion-weighted MRI were highly predictive of good 90-day clinical outcome, independent of total infarct volume. (C) RSNA, 2021
ER -
OSPEL, J. M., B.K. MENON, W. QIU, N. KASHANI, A. MAYANK, N. SINGH, Petra CIMFLOVÁ, M. MARKO, R. G. NOGUEIRA, R. A. MCTAGGART, A. M. DEMCHUK, A. Y. POPPE, C. ZERNA, M. JOSHI, M. A. ALMEKHLAFI, D. HAUSSEN, S. CUTTING, S. B.. COUTTS, D. ROY, A. ROHR, D. IANCU, M. TYMIANSKI, M. D. HILL and M. GOYAL. A Detailed Analysis of Infarct Patterns and Volumes at 24-hour Noncontrast CT and Diffusion-weighted MRI in Acute Ischemic Stroke Due to Large Vessel Occlusion: Results from the ESCAPE-NA1 Trial. \textit{Radiology}. Chicago: The Radiological Society of North America, 2021, vol.~300, No~1, p.~152-159. ISSN~0033-8419. Available from: https://dx.doi.org/10.1148/radiol.2021203964.
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