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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Applied Neuroimaging
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1476937
This article is part of the Research Topic Advanced Neuroimaging Techniques for Assessing Cerebrovascular Diseases View all 4 articles

Prognostic Value of Multi-PLD ASL-based Cerebral Perfusion ASPECTS in Acute Ischemic Stroke

Provisionally accepted
Qingqing Li Qingqing Li 1Chaojun Jiang Chaojun Jiang 2*Linqing Qian Linqing Qian 1*Jing Yang Jing Yang 1*Tianchi Mu Tianchi Mu 3*Congsong Dong Congsong Dong 3*Shu Wang Shu Wang 3*Zhenyu Wang Zhenyu Wang 3*Hengheng Liu Hengheng Liu 3Yijun Dong Yijun Dong 3*Zhenyu Dai Zhenyu Dai 3*Fei Chen Fei Chen 3*
  • 1 Suzhou Wuzhong People’s Hospital, Suzhou, Jiangsu Province, China
  • 2 Danyang People's Hospital, Danyang, Jiangsu Province, China
  • 3 Yancheng Third People's Hospital, Yancheng, China

The final, formatted version of the article will be published soon.

    Early CT Score (ASPECTS) based on multiple post-labeling delay (multi-PLD) arterial spin labeling (ASL) for outcome assessment in acute ischemic stroke (AIS) patients.The endpoint was modified Rankin scale score at 90 days (90-day mRS).Patients were divided into the good outcome (0~2) and poor outcome (3~6) groups. The independent samples t-test, Mann-Whitney U-test, and χ 2 test were used to compare clinical and imaging parameters between groups. We used partial correlation analysis to evaluate the relationships between ASPECTS and outcomes. Multivariate logistic regression analysis was used to examine potential independent prognostic indicators.The receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of the independent prognostic indicators in predicting outcomes.Results: 55 AIS patients were included. The good outcome group had a lower baseline National Institutes of Health Stroke Scale (NIHSS) (Z = -3.413, P < 0.001) and infarct core volume (ICV) (Z = -3.114, P = 0.002) as well as higher cerebral blood flow (CBF)-ASPECTS (Z = -3.835, P < 0.001) and cerebral blood volume (CBV)-ASPECTS (Z = -4.099, P < 0.001). Higher CBF-ASPECTS (r = -0.459, P = 0.001), and CBV-ASPECTS (r = -0.502, P < 0.001) were associated with a lower 90-day mRS. The baseline NIHSS, CBF-ASPECTS, and CBV-ASPECTS were identified as independent prognostic indicators. The AUCs of the baseline NIHSS, CBF-ASPECTS, and CBV-ASPECTS were 83.3%, 87.4%, and 89.9%, respectively. Combining NIHSS with CBF-ASPECTS and CBV-ASPECTS, the AUC significantly improved to 96.3%. The combined three factors showed a significant difference compared to the baseline NIHSS (Z = 2.039, P = 0.041) and CBF-ASPECTS (Z = 2.099, P = 0.036), but no difference with CBV-ASPECTS (Z = 1.176, P = 0.239).The ASPECTS based on multi-PLD ASL is a valuable tool for identifying independent prognostic indicators and assessing clinical outcomes in AIS patients. The baseline NIHSS, combined with CBF-ASPECTS and CBV-ASPECTS, enhances the predictive efficacy of clinical outcomes in AIS patients. The CBV-ASPECTS alone can offer comparable predictive efficacy to the combination.

    Keywords: Acute ischemic stroke, Alberta stroke program early CT score, Arterial Spin Labeling, cerebral blood flow, cerebral blood volume

    Received: 06 Aug 2024; Accepted: 27 Sep 2024.

    Copyright: © 2024 Li, Jiang, Qian, Yang, Mu, Dong, Wang, Wang, Liu, Dong, Dai and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Chaojun Jiang, Danyang People's Hospital, Danyang, Jiangsu Province, China
    Linqing Qian, Suzhou Wuzhong People’s Hospital, Suzhou, Jiangsu Province, China
    Jing Yang, Suzhou Wuzhong People’s Hospital, Suzhou, Jiangsu Province, China
    Tianchi Mu, Yancheng Third People's Hospital, Yancheng, China
    Congsong Dong, Yancheng Third People's Hospital, Yancheng, China
    Shu Wang, Yancheng Third People's Hospital, Yancheng, China
    Zhenyu Wang, Yancheng Third People's Hospital, Yancheng, China
    Yijun Dong, Yancheng Third People's Hospital, Yancheng, China
    Zhenyu Dai, Yancheng Third People's Hospital, Yancheng, China
    Fei Chen, Yancheng Third People's Hospital, Yancheng, China

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