Parenchymal FLAIR hyperintensity before thrombolysis is a prognostic factor of ischemic stroke outcome at 3 Tesla
Résumé
BACKGROUND: The goal of the present study was to determine whether the presence or absence of parenchymal FLAIR hyperintensity alone, before thrombolysis, might be a predictive factor of ischemic stroke outcomes after the acute phase of stroke and at 3 months. MATERIALS AND METHODS: We retrospectively included 84 patients with an ischemic stroke between November 2007 and March 2012, who underwent 3T MRI, were treated by thrombolysis, and had medical follow-up at 3 months. Two readers analyzed parenchymal FLAIR visibility. Logistic regressions were performed for NIHSS difference (NIHSS at admission - NIHSS at the end of hospitalization) and for 3 months modified Ranking Score (mRS). Predictive values of positive parenchymal FLAIR for identifying poor outcome at discharge and at 3 months were estimated. RESULTS: Parenchymal FLAIR positivity was not predictive of NIHSS difference but it predicted poor outcome at 3 months (sensitivity: 0.49 [0.37-0.60], specificity: 0.69 [0.46-0.91], positive predictive value: 0.87 [0.76-0.98] and negative predictive value: 0.24 [0.12-0.36]). CONCLUSIONS: At 3 Tesla, the presence of a parenchymal hyperintense FLAIR signal before thrombolysis is predictive of a poor clinical outcome at 3 months.
Mots clés
Female
Brain
France
Retrospective Studies
Reproducibility of Results
Prognosis
Patient outcomes
Outcome Assessment (Health Care)
Prevalence
Acute stroke
Aged
Assessments
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Risk Assessment
Risk Factors
Sensitivity and Specificity
Stroke
Survival Rate
Therapeutic thrombolysis
Thrombolytic Therapy