Deep profiling of multiple ischemic lesions in a large, multi-center cohort: Frequency, spatial distribution, and associations to clinical characteristics.
Deep profiling of multiple ischemic lesions in a large, multi-center cohort: Frequency, spatial distribution, and associations to clinical characteristics.
复制标题
DOI：
10.3389/fnins.2022.994458
复制
发表时间：
2022
影响因子：
4.3
通讯作者：
Wasselius, Johan
中科院分区：
文献类型：
--
作者：
Bonkhoff, Anna K.;Ullberg, Teresa;Bretzner, Martin;Hong, Sungmin;Schirmer, Markus D.;Regenhardt, Robert W.;Donahue, Kathleen L.;Nardin, Marco J.;Dalca, Adrian, V;Giese, Anne-Katrin;Etherton, Mark R.;Hancock, Brandon L.;Mocking, Steven J. T.;McIntosh, Elissa C.;Attia, John;Cole, John W.;Donatti, Amanda;Griessenauer, Christoph J.;Heitsch, Laura;Holmegaard, Lukas;Jood, Katarina;Jimenez-Conde, Jordi;Kittner, Steven J.;Lemmens, Robin;Levi, Christopher R.;McDonough, Caitrin W.;Meschia, James F.;Phuah, Chia-Ling;Ropele, Stefan;Rosand, Jonathan;Roquer, Jaume;Rundek, Tatjana;Sacco, Ralph L.;Schmidt, Reinhold;Sharma, Pankaj;Slowik, Agnieszka;Sousa, Alessandro;Stanne, Tara M.;Strbian, Daniel;Tatlisumak, Turgut;Thijs, Vincent;Vagal, Achala;Woo, Daniel;Zand, Ramin;McArdle, Patrick F.;Worrall, Bradford B.;Jern, Christina;Lindgren, Arne G.;Maguire, Jane;Wu, Ona;Frid, Petrea;Rost, Natalia S.;Wasselius, Johan
关键词：
大量急性缺血性卒中（AIS）患者出现多发性急性病变（MAL）。我们的目的是在一个大型的放射学深度表型队列中仔细检查MAL。分析依赖于国际MRI-GENIE研究的成像和临床数据。成像数据包括用于白色高信号（WMH）负荷估计的液体衰减反转恢复（FLAIR）和用于评估急性卒中病变的弥散加权成像（DWI）序列。第一步的特点是系统评价MAL在一个和几个血管供应区域内的发生率。随后确定MAL与重要影像学和临床特征之间的关联。通过贝叶斯分层回归模型对卒中严重程度和功能结局进行评估，评估单处和多处病变状态与病变体积之间的相互作用。我们分析了2，466例患者（年龄= 63.4 ± 14.8，39%为女性），其中49.7%为单一病变。另外37.4%的患者在单个血管区域发生MAL，而12.9%的患者在多个血管区域发生病变。在大多数区域内，MAL的发生频率与单个病变相同（比例为1：1）。只有脑干区的MAL患者较少（比例为1：4）。MAL患者的病变体积和急性NIHSS显著更高（7.7 vs. 1.7 ml和4 vs. 3，pFDR < 0.001）。相比之下，具有单一病变的患者的特征在于显著更高的WMH负荷（6.1 vs. 5.3 ml，pFDR = 0.048）。单处与多处病变患者的功能结局无显著差异。贝叶斯分析表明，在前循环卒中的情况下，单处和多处病变的病变体积与卒中严重程度之间的相关性是相同的。在后循环卒中的病例中，只有MAL患者的病变体积与较高的NIHSS相关。多发性病变，尤其是一个血管区域内的病变，比以前报道的更常见。总体而言，多发性病变与较高的急性卒中严重程度、较高的DWI总病变体积和较低的WMH病变体积明显相关。在后循环卒中中，病变体积仅与多发病变的卒中严重程度较高相关。
A substantial number of patients with acute ischemic stroke (AIS) experience multiple acute lesions (MAL). We here aimed to scrutinize MAL in a large radiologically deep-phenotyped cohort. Analyses relied upon imaging and clinical data from the international MRI-GENIE study. Imaging data comprised both Fluid-attenuated inversion recovery (FLAIR) for white matter hyperintensity (WMH) burden estimation and diffusion-weighted imaging (DWI) sequences for the assessment of acute stroke lesions. The initial step featured the systematic evaluation of occurrences of MAL within one and several vascular supply territories. Associations between MAL and important imaging and clinical characteristics were subsequently determined. The interaction effect between single and multiple lesion status and lesion volume was estimated by means of Bayesian hierarchical regression modeling for both stroke severity and functional outcome. We analyzed 2,466 patients (age = 63.4 ± 14.8, 39% women), 49.7% of which presented with a single lesion. Another 37.4% experienced MAL in a single vascular territory, while 12.9% featured lesions in multiple vascular territories. Within most territories, MAL occurred as frequently as single lesions (ratio ∼1:1). Only the brainstem region comprised fewer patients with MAL (ratio 1:4). Patients with MAL presented with a significantly higher lesion volume and acute NIHSS (7.7 vs. 1.7 ml and 4 vs. 3, pFDR < 0.001). In contrast, patients with a single lesion were characterized by a significantly higher WMH burden (6.1 vs. 5.3 ml, pFDR = 0.048). Functional outcome did not differ significantly between patients with single versus multiple lesions. Bayesian analyses suggested that the association between lesion volume and stroke severity between single and multiple lesions was the same in case of anterior circulation stroke. In case of posterior circulation stroke, lesion volume was linked to a higher NIHSS only among those with MAL. Multiple lesions, especially those within one vascular territory, occurred more frequently than previously reported. Overall, multiple lesions were distinctly linked to a higher acute stroke severity, a higher total DWI lesion volume and a lower WMH lesion volume. In posterior circulation stroke, lesion volume was linked to a higher stroke severity in multiple lesions only.
登录
查看更多内容
急性缺血性中风后的结果与性别特异性病变模式有关。
影响因子：
16.6
作者：
Bonkhoff AK;Schirmer MD;Bretzner M;Hong S;Regenhardt RW;Brudfors M;Donahue KL;Nardin MJ;Dalca AV;Giese AK;Etherton MR;Hancock BL;Mocking SJT;McIntosh EC;Attia J;Benavente OR;Bevan S;Cole JW;Donatti A;Griessenauer CJ;Heitsch L;Holmegaard L;Jood K;Jimenez-Conde J;Kittner SJ;Lemmens R;Levi CR;McDonough CW;Meschia JF;Phuah CL;Rolfs A;Ropele S;Rosand J;Roquer J;Rundek T;Sacco RL;Schmidt R;Sharma P;Slowik A;Söderholm M;Sousa A;Stanne TM;Strbian D;Tatlisumak T;Thijs V;Vagal A;Wasselius J;Woo D;Zand R;McArdle PF;Worrall BB;Jern C;Lindgren AG;Maguire J;Bzdok D;Wu O;MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium;Rost NS
通讯作者：
Rost NS
影响因子：
9.9
作者：
Erler, Kimberly S.;Wu, Rui;Lin, David J.
通讯作者：
Lin, David J.
影响因子：
4.3
作者：
Bretzner M;Bonkhoff AK;Schirmer MD;Hong S;Dalca AV;Donahue KL;Giese AK;Etherton MR;Rist PM;Nardin M;Marinescu R;Wang C;Regenhardt RW;Leclerc X;Lopes R;Benavente OR;Cole JW;Donatti A;Griessenauer CJ;Heitsch L;Holmegaard L;Jood K;Jimenez-Conde J;Kittner SJ;Lemmens R;Levi CR;McArdle PF;McDonough CW;Meschia JF;Phuah CL;Rolfs A;Ropele S;Rosand J;Roquer J;Rundek T;Sacco RL;Schmidt R;Sharma P;Slowik A;Sousa A;Stanne TM;Strbian D;Tatlisumak T;Thijs V;Vagal A;Wasselius J;Woo D;Wu O;Zand R;Worrall BB;Maguire JM;Lindgren A;Jern C;Golland P;Kuchcinski G;Rost NS
通讯作者：
Rost NS
影响因子：
9.9
作者：
Baird, AE;Lövblad, KO;Warach, S
通讯作者：
Warach, S
影响因子：
9.9
作者：
Arsava, E. M.;Ballabio, E.;Ay, H.
通讯作者：
Ay, H.