Diagnostic and prediction value of synthetic magnetic resonance imaging in acute ischemic stroke patients.

Abstract

Background: Current knowledge regarding synthetic magnetic resonance imaging in ischemic stroke (MAGiC) is inadequate.

Objectives: The study aimed to investigate the diagnostic and prognostic prediction value of MAGiC in acute ischemic stroke (AIS) patients.

Material and methods: This prospective observational study enrolled 197 AIS patients between January 2022 and May 2023. All patients underwent routine magnetic resonance imaging (MRI), computed tomography (CT) scans, doppler ultrasound, MAGiC, and dynamic contrast-enhanced (DCE)-MRI. The levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-ch), low-density lipoprotein cholesterol (LDL-ch), C-reactive protein (CRP), and procalcitonin (PCT) were also measured, and the National Institutes of Health Stroke Scale (NIHSS) was used to evaluate stroke severity.

Results: T2 and proton density (PD) values were markedly lower in severe patients than in mild-to-moderate patients, and the DCE-MRI Ktrans value was substantially higher in severe patients compared to mild-to-moderate patients. Furthermore, T2 and PD correlated negatively, while Ktrans correlated positively with CRP. Receiver operating characteristic (ROC) showed T2 and Ktrans to have the best diagnostic potential as MAGiC and DCE-MRI parameters, respectively. As such, combining T2 and Ktrans could improve severe stroke diagnosis accuracy. Moreover, TG, LDL-ch, CRP, T2, and Ktrans were independent risk factors for severe stroke.

Conclusions: T2 and PD MAGiC parameters and the DCE-MRI Ktrans parameter could be used as indices to predict severe stroke, while combining T2 and Ktrans might provide better diagnostic accuracy.