Arterial transit artifact as a short-term prognostic indicator in acute ischemic stroke
Abstract Background Arterial transit artifact (ATA) observed on arterial spin labeling (ASL) was recently suggested to be associated with improved functional outcomes following acute ischemic stroke (AIS). AIS is a heterogeneous disease with diverse pathogenic mechanisms depending on the stroke subt...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-024-03560-z |
| _version_ | 1797274260909064192 |
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| author | Min Shan Kaili Liu Yi Ma Qingxiu Zhang Wenwei Yun Min Zhang |
| author_facet | Min Shan Kaili Liu Yi Ma Qingxiu Zhang Wenwei Yun Min Zhang |
| author_sort | Min Shan |
| collection | DOAJ |
| description | Abstract Background Arterial transit artifact (ATA) observed on arterial spin labeling (ASL) was recently suggested to be associated with improved functional outcomes following acute ischemic stroke (AIS). AIS is a heterogeneous disease with diverse pathogenic mechanisms depending on the stroke subtype. This study aimed to investigate the association between ATA and 3-month functional outcomes in AIS patients according to etiology subtypes. Methods Consecutive patients with AIS were included. All patients underwent ASL MRI with postlabeling delay (PLD) of 1.5 and 2.5 s. ATA was assessed from the ASL images of both PLDs. Stroke etiologic subtypes were determined according to the modified TOAST (Trial of ORG 10172 in Acute Stroke Treatment) classification. Short-term functional outcomes were evaluated using the 3-month modified Rankin scale (mRS). Log-binomial regression was applied to analyze the association between ATA and functional outcomes at 3 months after stroke. Results Ninety-eight AIS patients (62.73 ± 13.05 years; 68 men) were finally included. ATA was detected in forty-six patients and most frequently seen in the large-artery atherosclerosis (LAA) subtype (35/46). The ATA group exhibited a lower percentage of patients with mRS > 2 compared to the group without ATA (36.5% vs. 19.6%; P < 0.001). ATA was independently associated with better 3-month clinical outcomes (adjusted risk ratio, 0.35[95% CI, 0.16—0.74]) in the multivariate log-binomial regression model. After stratification by TOAST subtypes, a significant association was found between ATA and better outcomes in the LAA subtype (adjusted risk ratio, 0.20[ 95% CI, 0.05—0.72]) but not in cardioembolism and small artery occlusion (SVO) subtype. Conclusion ATA is associated with better outcomes at 3 months in patients with AIS, especially in the LAA subtype, but this association attenuated in the cardioembolism and SVO subtypes. |
| first_indexed | 2024-03-07T14:55:51Z |
| format | Article |
| id | doaj.art-d286593f2de643c6a7f0df1c928baeed |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-03-07T14:55:51Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-d286593f2de643c6a7f0df1c928baeed2024-03-05T19:28:01ZengBMCBMC Neurology1471-23772024-02-012411910.1186/s12883-024-03560-zArterial transit artifact as a short-term prognostic indicator in acute ischemic strokeMin Shan0Kaili Liu1Yi Ma2Qingxiu Zhang3Wenwei Yun4Min Zhang5Department of Neurology, the Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou Second People’s Hospital, Changzhou Medical Center, Nanjing Medical UniversityDepartment of Radiology, the Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou Second People’s Hospital, Changzhou Medical Center, Nanjing Medical UniversityDepartment of Radiology, the Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou Second People’s Hospital, Changzhou Medical Center, Nanjing Medical UniversityDepartment of Neurology, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing UniversityDepartment of Neurology, the Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou Second People’s Hospital, Changzhou Medical Center, Nanjing Medical UniversityDepartment of Neurology, the Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou Second People’s Hospital, Changzhou Medical Center, Nanjing Medical UniversityAbstract Background Arterial transit artifact (ATA) observed on arterial spin labeling (ASL) was recently suggested to be associated with improved functional outcomes following acute ischemic stroke (AIS). AIS is a heterogeneous disease with diverse pathogenic mechanisms depending on the stroke subtype. This study aimed to investigate the association between ATA and 3-month functional outcomes in AIS patients according to etiology subtypes. Methods Consecutive patients with AIS were included. All patients underwent ASL MRI with postlabeling delay (PLD) of 1.5 and 2.5 s. ATA was assessed from the ASL images of both PLDs. Stroke etiologic subtypes were determined according to the modified TOAST (Trial of ORG 10172 in Acute Stroke Treatment) classification. Short-term functional outcomes were evaluated using the 3-month modified Rankin scale (mRS). Log-binomial regression was applied to analyze the association between ATA and functional outcomes at 3 months after stroke. Results Ninety-eight AIS patients (62.73 ± 13.05 years; 68 men) were finally included. ATA was detected in forty-six patients and most frequently seen in the large-artery atherosclerosis (LAA) subtype (35/46). The ATA group exhibited a lower percentage of patients with mRS > 2 compared to the group without ATA (36.5% vs. 19.6%; P < 0.001). ATA was independently associated with better 3-month clinical outcomes (adjusted risk ratio, 0.35[95% CI, 0.16—0.74]) in the multivariate log-binomial regression model. After stratification by TOAST subtypes, a significant association was found between ATA and better outcomes in the LAA subtype (adjusted risk ratio, 0.20[ 95% CI, 0.05—0.72]) but not in cardioembolism and small artery occlusion (SVO) subtype. Conclusion ATA is associated with better outcomes at 3 months in patients with AIS, especially in the LAA subtype, but this association attenuated in the cardioembolism and SVO subtypes.https://doi.org/10.1186/s12883-024-03560-zArterial spin labelingMagnetic resonance imagingArterial transit artifactAcute ischemic strokeStroke subtypes |
| spellingShingle | Min Shan Kaili Liu Yi Ma Qingxiu Zhang Wenwei Yun Min Zhang Arterial transit artifact as a short-term prognostic indicator in acute ischemic stroke BMC Neurology Arterial spin labeling Magnetic resonance imaging Arterial transit artifact Acute ischemic stroke Stroke subtypes |
| title | Arterial transit artifact as a short-term prognostic indicator in acute ischemic stroke |
| title_full | Arterial transit artifact as a short-term prognostic indicator in acute ischemic stroke |
| title_fullStr | Arterial transit artifact as a short-term prognostic indicator in acute ischemic stroke |
| title_full_unstemmed | Arterial transit artifact as a short-term prognostic indicator in acute ischemic stroke |
| title_short | Arterial transit artifact as a short-term prognostic indicator in acute ischemic stroke |
| title_sort | arterial transit artifact as a short term prognostic indicator in acute ischemic stroke |
| topic | Arterial spin labeling Magnetic resonance imaging Arterial transit artifact Acute ischemic stroke Stroke subtypes |
| url | https://doi.org/10.1186/s12883-024-03560-z |
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