Computed tomography derived cervical fat-free muscle fraction as an imaging-based outcome marker in patients with acute ischemic stroke: a pilot study
Abstract Background Outcome assessment in stroke patients is essential for evidence-based stroke care planning. Computed tomography (CT) is the mainstay of diagnosis in acute stroke. This study aimed to investigate whether CT-derived cervical fat-free muscle fraction (FFMF) as a biomarker of muscle...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-023-03132-7 |
| _version_ | 1797864384850034688 |
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| author | Narine Mesropyan Louisa Khorsandian Anton Faron Alois M. Sprinkart Franziska Dorn Daniel Paech Alexander Isaak Daniel Kuetting Claus C. Pieper Alexander Radbruch Ulrike I. Attenberger Jens Reimann Felix J. Bode Cornelia Kornblum Julian A. Luetkens |
| author_facet | Narine Mesropyan Louisa Khorsandian Anton Faron Alois M. Sprinkart Franziska Dorn Daniel Paech Alexander Isaak Daniel Kuetting Claus C. Pieper Alexander Radbruch Ulrike I. Attenberger Jens Reimann Felix J. Bode Cornelia Kornblum Julian A. Luetkens |
| author_sort | Narine Mesropyan |
| collection | DOAJ |
| description | Abstract Background Outcome assessment in stroke patients is essential for evidence-based stroke care planning. Computed tomography (CT) is the mainstay of diagnosis in acute stroke. This study aimed to investigate whether CT-derived cervical fat-free muscle fraction (FFMF) as a biomarker of muscle quality is associated with outcome parameters after acute ischemic stroke. Methods In this retrospective study, 66 patients (mean age: 76 ± 13 years, 30 female) with acute ischemic stroke in the anterior circulation who underwent CT, including CT-angiography, and endovascular mechanical thrombectomy of the middle cerebral artery between August 2016 and January 2020 were identified. Based on densitometric thresholds, cervical paraspinal muscles covered on CT-angiography were separated into areas of fatty and lean muscle and FFMF was calculated. The study cohort was binarized based on median FFMF (cutoff value: < 71.6%) to compare clinical variables and outcome data between two groups. Unpaired t test and Mann-Whitney U test were used for statistical analysis. Results National Institute of Health Stroke Scale (NIHSS) (12.2 ± 4.4 vs. 13.6 ± 4.5, P = 0.297) and modified Rankin scale (mRS) (4.3 ± 0.9 vs. 4.4 ± 0.9, P = 0.475) at admission, and pre-stroke mRS (1 ± 1.3 vs. 0.9 ± 1.4, P = 0.489) were similar between groups with high and low FFMF. NIHSS and mRS at discharge were significantly better in patients with high FFMF compared to patients with low FFMF (NIHSS: 4.5 ± 4.4 vs. 9.5 ± 6.7; P = 0.004 and mRS: 2.9 ± 2.1 vs.3.9 ± 1.8; P = 0.049). 90-day mRS was significantly better in patients with high FFMF compared to patients with low FFMF (3.3 ± 2.2 vs. 4.3 ± 1.9, P = 0.045). Conclusion Cervical FFMF obtained from routine clinical CT might be a new imaging-based muscle quality biomarker for outcome prediction in stroke patients. |
| first_indexed | 2024-04-09T22:52:02Z |
| format | Article |
| id | doaj.art-ce094948ac1343638761bcd1d7ee33da |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-04-09T22:52:02Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-ce094948ac1343638761bcd1d7ee33da2023-03-22T11:38:01ZengBMCBMC Neurology1471-23772023-02-0123111010.1186/s12883-023-03132-7Computed tomography derived cervical fat-free muscle fraction as an imaging-based outcome marker in patients with acute ischemic stroke: a pilot studyNarine Mesropyan0Louisa Khorsandian1Anton Faron2Alois M. Sprinkart3Franziska Dorn4Daniel Paech5Alexander Isaak6Daniel Kuetting7Claus C. Pieper8Alexander Radbruch9Ulrike I. Attenberger10Jens Reimann11Felix J. Bode12Cornelia Kornblum13Julian A. Luetkens14Department of Diagnostic and Interventional Radiology, University Hospital BonnDepartment of Diagnostic and Interventional Radiology, University Hospital BonnDepartment of Diagnostic and Interventional Radiology, University Hospital BonnDepartment of Diagnostic and Interventional Radiology, University Hospital BonnDepartment of Neuroradiology, University Hospital BonnDepartment of Neuroradiology, University Hospital BonnDepartment of Diagnostic and Interventional Radiology, University Hospital BonnDepartment of Diagnostic and Interventional Radiology, University Hospital BonnDepartment of Diagnostic and Interventional Radiology, University Hospital BonnDepartment of Neuroradiology, University Hospital BonnDepartment of Diagnostic and Interventional Radiology, University Hospital BonnDepartment of Neurology, University Hospital BonnDepartment of Neurology, University Hospital BonnDepartment of Neurology, University Hospital BonnDepartment of Diagnostic and Interventional Radiology, University Hospital BonnAbstract Background Outcome assessment in stroke patients is essential for evidence-based stroke care planning. Computed tomography (CT) is the mainstay of diagnosis in acute stroke. This study aimed to investigate whether CT-derived cervical fat-free muscle fraction (FFMF) as a biomarker of muscle quality is associated with outcome parameters after acute ischemic stroke. Methods In this retrospective study, 66 patients (mean age: 76 ± 13 years, 30 female) with acute ischemic stroke in the anterior circulation who underwent CT, including CT-angiography, and endovascular mechanical thrombectomy of the middle cerebral artery between August 2016 and January 2020 were identified. Based on densitometric thresholds, cervical paraspinal muscles covered on CT-angiography were separated into areas of fatty and lean muscle and FFMF was calculated. The study cohort was binarized based on median FFMF (cutoff value: < 71.6%) to compare clinical variables and outcome data between two groups. Unpaired t test and Mann-Whitney U test were used for statistical analysis. Results National Institute of Health Stroke Scale (NIHSS) (12.2 ± 4.4 vs. 13.6 ± 4.5, P = 0.297) and modified Rankin scale (mRS) (4.3 ± 0.9 vs. 4.4 ± 0.9, P = 0.475) at admission, and pre-stroke mRS (1 ± 1.3 vs. 0.9 ± 1.4, P = 0.489) were similar between groups with high and low FFMF. NIHSS and mRS at discharge were significantly better in patients with high FFMF compared to patients with low FFMF (NIHSS: 4.5 ± 4.4 vs. 9.5 ± 6.7; P = 0.004 and mRS: 2.9 ± 2.1 vs.3.9 ± 1.8; P = 0.049). 90-day mRS was significantly better in patients with high FFMF compared to patients with low FFMF (3.3 ± 2.2 vs. 4.3 ± 1.9, P = 0.045). Conclusion Cervical FFMF obtained from routine clinical CT might be a new imaging-based muscle quality biomarker for outcome prediction in stroke patients.https://doi.org/10.1186/s12883-023-03132-7Acute ischemic strokeComputed tomographyMuscle qualityFat-free muscle fraction |
| spellingShingle | Narine Mesropyan Louisa Khorsandian Anton Faron Alois M. Sprinkart Franziska Dorn Daniel Paech Alexander Isaak Daniel Kuetting Claus C. Pieper Alexander Radbruch Ulrike I. Attenberger Jens Reimann Felix J. Bode Cornelia Kornblum Julian A. Luetkens Computed tomography derived cervical fat-free muscle fraction as an imaging-based outcome marker in patients with acute ischemic stroke: a pilot study BMC Neurology Acute ischemic stroke Computed tomography Muscle quality Fat-free muscle fraction |
| title | Computed tomography derived cervical fat-free muscle fraction as an imaging-based outcome marker in patients with acute ischemic stroke: a pilot study |
| title_full | Computed tomography derived cervical fat-free muscle fraction as an imaging-based outcome marker in patients with acute ischemic stroke: a pilot study |
| title_fullStr | Computed tomography derived cervical fat-free muscle fraction as an imaging-based outcome marker in patients with acute ischemic stroke: a pilot study |
| title_full_unstemmed | Computed tomography derived cervical fat-free muscle fraction as an imaging-based outcome marker in patients with acute ischemic stroke: a pilot study |
| title_short | Computed tomography derived cervical fat-free muscle fraction as an imaging-based outcome marker in patients with acute ischemic stroke: a pilot study |
| title_sort | computed tomography derived cervical fat free muscle fraction as an imaging based outcome marker in patients with acute ischemic stroke a pilot study |
| topic | Acute ischemic stroke Computed tomography Muscle quality Fat-free muscle fraction |
| url | https://doi.org/10.1186/s12883-023-03132-7 |
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