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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1519894
This article is part of the Research Topic Neurosonology in Stroke View all 3 articles

Small Subcortical Ischemic Infarction and other DWI lesions establish predictive model for MES

Provisionally accepted
Zhao Liming Zhao Liming 1Yicheng Xu Yicheng Xu 2Zhao Hongqin Zhao Hongqin 3Wang Senlin Wang Senlin 4Zhang Aijuan Zhang Aijuan 5Jiatang Zhang Jiatang Zhang 6Tian Chenlin Tian Chenlin 6Zhang Zengchao Zhang Zengchao 7Ji Tailing Ji Tailing 7Zhengang Wang Zhengang Wang 1*
  • 1 Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, China
  • 2 Department of Neurology, Aerospace Center Hospital, Beijing, China
  • 3 Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
  • 4 Department of neurosurgeon, Second People’s Hospital of Weifang, Weifang, Shandong Province, China
  • 5 Department of neurology, Weifang People's Hospital, Weifang, Shandong Province, China
  • 6 Department of Neurology, Chinese PLA General Hospital, Beijing, Beijing Municipality, China
  • 7 Department of neurosurgeon, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, China

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

    The relationship between small subcortical ischemic infarction remains poorly characterized. Therefore, the present study aimed to investigate the association between artery-to-artery embolization and small subcortical infarctions.: This retrospective observational cross-sectional study enrolling 230 patients with acute middle cerebral artery (MCA) stroke classified into the microembolic signals-positive (MES+) and MES-negative (MES-) groups. The diffusion weighted imaging (DWI) infarction patterns in the MCA were divided into the territorial, border zone (BZ), cortical, and subcortical infarcts. We set the standard of small subcortical infarction (SCI) into two levels: < 10 mm diameter and < 5 mm diameter. Relevant DWI parameters were used to build a nomogram for MES+, using free statistics. Results: MES occurred in 38 of the 230 cases, yielding a positivity rate of 16.5%. BZ, SCI <10 mm, cortical ischemia (CI), stenosis, white blood cell count, and gender were compared between the MES+ and MES-groups. Multivariate analysis revealed that BZ, SCI<10 mm, and CI were independently associated with MES. Based on DWI parameters, a nomogram model was built for MES+. The area under the curve of the model was 0.826(95%CI 0.764 to 0.889). In internal cross-validation, the slope of the calibration curve was 1.000, indicating that the model accurately predicted unsuccessful treatment outcomes. Conclusions: Small subcortical infarctions are associated with MES. In the present study, we built a predictive nomogram model for MES+ based on small subcortical infarctions and other DWI parameters. This model demonstrated good performance in clinical practice.

    Keywords: microembolic signals (MES), Lesion pattern, Subcortical infarction, nomogram, border zone (BZ)

    Received: 30 Oct 2024; Accepted: 24 Dec 2024.

    Copyright: © 2024 Liming, Xu, Hongqin, Senlin, Aijuan, Zhang, Chenlin, Zengchao, Tailing and Wang. 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: Zhengang Wang, Affiliated Hospital of Weifang Medical University, Weifang, 261000, Shandong Province, China

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