The following is a summary of “Follow-up infarct volume on fluid attenuated inversion recovery (FLAIR) imaging in distal medium vessel occlusions: the role of cerebral blood volume index,” published in the March 2024 issue of Neurology by Salim et al.
Distal, medium vessel occlusions (DMVOs) are a significant contributor to acute ischemic strokes (AIS), but Fluid Attenuation Inversion Recovery (FLAIR) and cerebral blood volume (CBV) imaging help assess stroke impact and predict outcomes.
Researchers started a retrospective study to investigate the association between follow-up infarct volume (FIV) measured by FLAIR imaging in patients with DMVOs.
They involved patients from two stroke centers at Johns Hopkins Medical Enterprise (August 2018 to October 2022). AIS adults were included due to DMVO. Various imaging modalities were included, including non-contrast CT, CT angiography (CTA), CT perfusion (CTP), and FLAIR imaging. Univariable and multivariable linear regression models examined the relationship between different FIVs.
The results showed 79 DMVO stroke patients, with a median age of 69 years (IQR, 62–77 years), participated, among whom 57% (n = 45) were female. A negative correlation between the CBV index and FIV was observed in both univariable (Beta = – 16; 95% CI, – 23 to – 8.3; P<0.001) and multivariable linear regression (Beta = – 9.1 per 0.1 change; 95% CI, – 15 to – 2.7; P=0.006) analyses. Diabetes was independently associated with larger FIV (Beta = 46; 95% CI, 16 to 75; P=0.003). A higher baseline ASPECTS corresponded to a lower FIV (Beta = – 30; 95% CI, – 41 to – 20; P<0.001).
Investigators concluded that the CBV index was independently associated with FIV in DMVOs, underlining the critical role of collateral circulation in determining stroke outcomes in this patient population.
Source: link.springer.com/article/10.1007/s00415-024-12279-3