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Association Between Time From Stroke Onset and Fluid-Attenuated Inversion Recovery Lesion Intensity Is Modified by Status of Collateral Circulation.

Wouters, Anke; Dupont, Patrick; Christensen, Soren; Norrving, Bo LU ; Laage, Rico; Thomalla, Götz; Albers, Greg; Thijs, Vincent and Lemmens, Robin (2016) In Stroke; a journal of cerebral circulation 47. p.1018-1018
Abstract
BACKGROUND AND PURPOSE:

In patients with acute stroke, the intensity of a fluid-attenuated inversion recovery (FLAIR) lesion in the region of diffusion restriction is associated with time from symptom onset. We hypothesized that collateral status as assessed by the hypoperfusion intensity ratio could modify the association between time from stroke onset and FLAIR lesion intensity.
METHODS:

From the AX200 for ischemic stroke trial, 141 patients had appropriate FLAIR, diffusion-weighted imaging, and perfusion-weighted imaging. In the region of nonreperfused core, we calculated voxel-based relative FLAIR (rFLAIR) signal intensity. The hypoperfusion intensity ratio was defined as the ratio of the Tmax >10 s lesion over... (More)
BACKGROUND AND PURPOSE:

In patients with acute stroke, the intensity of a fluid-attenuated inversion recovery (FLAIR) lesion in the region of diffusion restriction is associated with time from symptom onset. We hypothesized that collateral status as assessed by the hypoperfusion intensity ratio could modify the association between time from stroke onset and FLAIR lesion intensity.
METHODS:

From the AX200 for ischemic stroke trial, 141 patients had appropriate FLAIR, diffusion-weighted imaging, and perfusion-weighted imaging. In the region of nonreperfused core, we calculated voxel-based relative FLAIR (rFLAIR) signal intensity. The hypoperfusion intensity ratio was defined as the ratio of the Tmax >10 s lesion over the Tmax >6 s lesion volume. A hypoperfusion intensity ratio threshold of ≤0.4 was used to dichotomize good versus poor collaterals. We studied the interaction between collateral status on the association between time from symptom onset and FLAIR intensity.
RESULTS:

Time from symptom onset was associated with the rFLAIR intensity in the region of nonreperfused core (B=1.05; 95% confidence interval, 1.0-1.1). We identified an interaction between this association and collateral status; an association was present between time and rFLAIR intensity in patients with poor collaterals (r=0.53), but absent in patients with good collaterals (r=0.17; P=0.04).
CONCLUSIONS:

Our findings show that the relationship between time from symptom onset and rFLAIR lesion intensity depends on collateral status. In patients with good collaterals, the development of an rFLAIR-positive lesion is less dependent on time from symptom onset compared with patients with poor collaterals. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Stroke; a journal of cerebral circulation
volume
47
pages
1022 pages
publisher
American Heart Association
external identifiers
  • pmid:26917566
  • scopus:84959184651
  • wos:000372853200018
ISSN
1524-4628
DOI
10.1161/STROKEAHA.115.012010
language
English
LU publication?
yes
id
137b478a-bb53-4fa5-b7ec-6680437a3430 (old id 8821583)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26917566?dopt=Abstract
date added to LUP
2016-03-03 12:02:45
date last changed
2017-06-25 03:50:46
@article{137b478a-bb53-4fa5-b7ec-6680437a3430,
  abstract     = {BACKGROUND AND PURPOSE:<br/><br/>In patients with acute stroke, the intensity of a fluid-attenuated inversion recovery (FLAIR) lesion in the region of diffusion restriction is associated with time from symptom onset. We hypothesized that collateral status as assessed by the hypoperfusion intensity ratio could modify the association between time from stroke onset and FLAIR lesion intensity.<br/>METHODS:<br/><br/>From the AX200 for ischemic stroke trial, 141 patients had appropriate FLAIR, diffusion-weighted imaging, and perfusion-weighted imaging. In the region of nonreperfused core, we calculated voxel-based relative FLAIR (rFLAIR) signal intensity. The hypoperfusion intensity ratio was defined as the ratio of the Tmax &gt;10 s lesion over the Tmax &gt;6 s lesion volume. A hypoperfusion intensity ratio threshold of ≤0.4 was used to dichotomize good versus poor collaterals. We studied the interaction between collateral status on the association between time from symptom onset and FLAIR intensity.<br/>RESULTS:<br/><br/>Time from symptom onset was associated with the rFLAIR intensity in the region of nonreperfused core (B=1.05; 95% confidence interval, 1.0-1.1). We identified an interaction between this association and collateral status; an association was present between time and rFLAIR intensity in patients with poor collaterals (r=0.53), but absent in patients with good collaterals (r=0.17; P=0.04).<br/>CONCLUSIONS:<br/><br/>Our findings show that the relationship between time from symptom onset and rFLAIR lesion intensity depends on collateral status. In patients with good collaterals, the development of an rFLAIR-positive lesion is less dependent on time from symptom onset compared with patients with poor collaterals.},
  author       = {Wouters, Anke and Dupont, Patrick and Christensen, Soren and Norrving, Bo and Laage, Rico and Thomalla, Götz and Albers, Greg and Thijs, Vincent and Lemmens, Robin},
  issn         = {1524-4628},
  language     = {eng},
  month        = {02},
  pages        = {1018--1018},
  publisher    = {American Heart Association},
  series       = {Stroke; a journal of cerebral circulation},
  title        = {Association Between Time From Stroke Onset and Fluid-Attenuated Inversion Recovery Lesion Intensity Is Modified by Status of Collateral Circulation.},
  url          = {http://dx.doi.org/10.1161/STROKEAHA.115.012010},
  volume       = {47},
  year         = {2016},
}