A retrospective analysis of a newly proposed imaging-etiologic classification for acute ischemic stroke with large vascular occlusion based on MRI and pathogenesis
Background Endovascular treatment (EVT) has emerged as the preferred initial therapeutic option for acute ischemic stroke (AIS) with large vascular occlusion (LVO). To facilitate more targeted EVT interventions, we propose a novel imaging-etiologic classification system derived from a comprehensive...
| Главные авторы: | , , , , , |
|---|---|
| Формат: | Статья |
| Язык: | English |
| Опубликовано: |
PeerJ Inc.
2024-10-01
|
| Серии: | PeerJ |
| Предметы: | |
| Online-ссылка: | https://peerj.com/articles/18342.pdf |
| _version_ | 1827046305219739648 |
|---|---|
| author | Hao Li Zhaoshuo Li Jinchao Xia Lijun Shen Guangming Duan Ziliang Wang |
| author_facet | Hao Li Zhaoshuo Li Jinchao Xia Lijun Shen Guangming Duan Ziliang Wang |
| author_sort | Hao Li |
| collection | DOAJ |
| description | Background Endovascular treatment (EVT) has emerged as the preferred initial therapeutic option for acute ischemic stroke (AIS) with large vascular occlusion (LVO). To facilitate more targeted EVT interventions, we propose a novel imaging-etiologic classification system derived from a comprehensive analysis of preoperative MRI and pathogenesis in AIS patients. Methods From June 2020 to December 2021, a retrospective analysis was conducted on 184 consecutive AIS patients who underwent preoperative MRI and subsequent EVT at the Henan Provincial Cerebrovascular Hospital Stroke Center. Patients’ medical histories were comprehensively reviewed. According to MRI, anterior circulation infarction (ACI) and posterior circulation infarction (PCI) were divided into four groups respectively (A-D & a-d). Three types (1–3) of etiology were identified based on pathogenesis. The types were respectively evaluated by screening test with intra-operative finding of EVT. Results Our imaging-etiologic classification achieved an overall positive rate of 90.2% (166/184) when compared to the gold standard. The screening test for each type demonstrated excellent validity (Youden’s index ≥ 0.75) and reliability (Kappa ≥ 0.80). Conclusion The imaging-etiologic classification represents a simple yet comprehensive approach that can be readily applied in the management of AIS with LVO. It can rapidly and effectively locate the vascular occlusion, and reveal the pathogenesis. |
| first_indexed | 2025-02-18T14:36:14Z |
| format | Article |
| id | doaj.art-96d30f8054cf42b09f8ca736d48c33c3 |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2025-02-18T14:36:14Z |
| publishDate | 2024-10-01 |
| publisher | PeerJ Inc. |
| record_format | Article |
| series | PeerJ |
| spelling | doaj.art-96d30f8054cf42b09f8ca736d48c33c32024-10-26T15:05:23ZengPeerJ Inc.PeerJ2167-83592024-10-0112e1834210.7717/peerj.18342A retrospective analysis of a newly proposed imaging-etiologic classification for acute ischemic stroke with large vascular occlusion based on MRI and pathogenesisHao Li0Zhaoshuo Li1Jinchao Xia2Lijun Shen3Guangming Duan4Ziliang Wang5Department of Cerebrovascular Disease, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, Henan, ChinaDepartment of Cerebrovascular Disease, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, Henan, ChinaDepartment of Cerebrovascular Disease, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, Henan, ChinaDepartment of Clinical Medical Research Center, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, Henan, ChinaDepartment of Cerebrovascular Disease, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, Henan, ChinaDepartment of Cerebrovascular Disease, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, Henan, ChinaBackground Endovascular treatment (EVT) has emerged as the preferred initial therapeutic option for acute ischemic stroke (AIS) with large vascular occlusion (LVO). To facilitate more targeted EVT interventions, we propose a novel imaging-etiologic classification system derived from a comprehensive analysis of preoperative MRI and pathogenesis in AIS patients. Methods From June 2020 to December 2021, a retrospective analysis was conducted on 184 consecutive AIS patients who underwent preoperative MRI and subsequent EVT at the Henan Provincial Cerebrovascular Hospital Stroke Center. Patients’ medical histories were comprehensively reviewed. According to MRI, anterior circulation infarction (ACI) and posterior circulation infarction (PCI) were divided into four groups respectively (A-D & a-d). Three types (1–3) of etiology were identified based on pathogenesis. The types were respectively evaluated by screening test with intra-operative finding of EVT. Results Our imaging-etiologic classification achieved an overall positive rate of 90.2% (166/184) when compared to the gold standard. The screening test for each type demonstrated excellent validity (Youden’s index ≥ 0.75) and reliability (Kappa ≥ 0.80). Conclusion The imaging-etiologic classification represents a simple yet comprehensive approach that can be readily applied in the management of AIS with LVO. It can rapidly and effectively locate the vascular occlusion, and reveal the pathogenesis.https://peerj.com/articles/18342.pdfAcute ischemic strokeEndovascular treatmentLarge vascular occlusionImaging-etiologic classification |
| spellingShingle | Hao Li Zhaoshuo Li Jinchao Xia Lijun Shen Guangming Duan Ziliang Wang A retrospective analysis of a newly proposed imaging-etiologic classification for acute ischemic stroke with large vascular occlusion based on MRI and pathogenesis PeerJ Acute ischemic stroke Endovascular treatment Large vascular occlusion Imaging-etiologic classification |
| title | A retrospective analysis of a newly proposed imaging-etiologic classification for acute ischemic stroke with large vascular occlusion based on MRI and pathogenesis |
| title_full | A retrospective analysis of a newly proposed imaging-etiologic classification for acute ischemic stroke with large vascular occlusion based on MRI and pathogenesis |
| title_fullStr | A retrospective analysis of a newly proposed imaging-etiologic classification for acute ischemic stroke with large vascular occlusion based on MRI and pathogenesis |
| title_full_unstemmed | A retrospective analysis of a newly proposed imaging-etiologic classification for acute ischemic stroke with large vascular occlusion based on MRI and pathogenesis |
| title_short | A retrospective analysis of a newly proposed imaging-etiologic classification for acute ischemic stroke with large vascular occlusion based on MRI and pathogenesis |
| title_sort | retrospective analysis of a newly proposed imaging etiologic classification for acute ischemic stroke with large vascular occlusion based on mri and pathogenesis |
| topic | Acute ischemic stroke Endovascular treatment Large vascular occlusion Imaging-etiologic classification |
| url | https://peerj.com/articles/18342.pdf |
| work_keys_str_mv | AT haoli aretrospectiveanalysisofanewlyproposedimagingetiologicclassificationforacuteischemicstrokewithlargevascularocclusionbasedonmriandpathogenesis AT zhaoshuoli aretrospectiveanalysisofanewlyproposedimagingetiologicclassificationforacuteischemicstrokewithlargevascularocclusionbasedonmriandpathogenesis AT jinchaoxia aretrospectiveanalysisofanewlyproposedimagingetiologicclassificationforacuteischemicstrokewithlargevascularocclusionbasedonmriandpathogenesis AT lijunshen aretrospectiveanalysisofanewlyproposedimagingetiologicclassificationforacuteischemicstrokewithlargevascularocclusionbasedonmriandpathogenesis AT guangmingduan aretrospectiveanalysisofanewlyproposedimagingetiologicclassificationforacuteischemicstrokewithlargevascularocclusionbasedonmriandpathogenesis AT ziliangwang aretrospectiveanalysisofanewlyproposedimagingetiologicclassificationforacuteischemicstrokewithlargevascularocclusionbasedonmriandpathogenesis AT haoli retrospectiveanalysisofanewlyproposedimagingetiologicclassificationforacuteischemicstrokewithlargevascularocclusionbasedonmriandpathogenesis AT zhaoshuoli retrospectiveanalysisofanewlyproposedimagingetiologicclassificationforacuteischemicstrokewithlargevascularocclusionbasedonmriandpathogenesis AT jinchaoxia retrospectiveanalysisofanewlyproposedimagingetiologicclassificationforacuteischemicstrokewithlargevascularocclusionbasedonmriandpathogenesis AT lijunshen retrospectiveanalysisofanewlyproposedimagingetiologicclassificationforacuteischemicstrokewithlargevascularocclusionbasedonmriandpathogenesis AT guangmingduan retrospectiveanalysisofanewlyproposedimagingetiologicclassificationforacuteischemicstrokewithlargevascularocclusionbasedonmriandpathogenesis AT ziliangwang retrospectiveanalysisofanewlyproposedimagingetiologicclassificationforacuteischemicstrokewithlargevascularocclusionbasedonmriandpathogenesis |