A retrospective analysis of a newly proposed imaging-etiologic classification for acute ischemic stroke with large vascular occlusion based on MRI and pathogenesis.

IF 2.3 3区 生物学 Q2 MULTIDISCIPLINARY SCIENCES
PeerJ Pub Date : 2024-10-24 eCollection Date: 2024-01-01 DOI:10.7717/peerj.18342
Hao Li, Zhaoshuo Li, Jinchao Xia, Lijun Shen, Guangming Duan, Ziliang Wang
{"title":"A retrospective analysis of a newly proposed imaging-etiologic classification for acute ischemic stroke with large vascular occlusion based on MRI and pathogenesis.","authors":"Hao Li, Zhaoshuo Li, Jinchao Xia, Lijun Shen, Guangming Duan, Ziliang Wang","doi":"10.7717/peerj.18342","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Endovascular treatment (EVT) has emerged as the preferred initial therapeutic option for acute ischemic stroke (AIS) with large vascular occlusion (LVO). To facilitate more targeted EVT interventions, we propose a novel imaging-etiologic classification system derived from a comprehensive analysis of preoperative MRI and pathogenesis in AIS patients.</p><p><strong>Methods: </strong>From June 2020 to December 2021, a retrospective analysis was conducted on 184 consecutive AIS patients who underwent preoperative MRI and subsequent EVT at the Henan Provincial Cerebrovascular Hospital Stroke Center. Patients' medical histories were comprehensively reviewed. According to MRI, anterior circulation infarction (ACI) and posterior circulation infarction (PCI) were divided into four groups respectively (A-D & a-d). Three types (1-3) of etiology were identified based on pathogenesis. The types were respectively evaluated by screening test with intra-operative finding of EVT.</p><p><strong>Results: </strong>Our imaging-etiologic classification achieved an overall positive rate of 90.2% (166/184) when compared to the gold standard. The screening test for each type demonstrated excellent validity (Youden's index ≥ 0.75) and reliability (Kappa ≥ 0.80).</p><p><strong>Conclusion: </strong>The imaging-etiologic classification represents a simple yet comprehensive approach that can be readily applied in the management of AIS with LVO. It can rapidly and effectively locate the vascular occlusion, and reveal the pathogenesis.</p>","PeriodicalId":19799,"journal":{"name":"PeerJ","volume":"12 ","pages":"e18342"},"PeriodicalIF":2.3000,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512804/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"PeerJ","FirstCategoryId":"99","ListUrlMain":"https://doi.org/10.7717/peerj.18342","RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MULTIDISCIPLINARY SCIENCES","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Endovascular treatment (EVT) has emerged as the preferred initial therapeutic option for acute ischemic stroke (AIS) with large vascular occlusion (LVO). To facilitate more targeted EVT interventions, we propose a novel imaging-etiologic classification system derived from a comprehensive analysis of preoperative MRI and pathogenesis in AIS patients.

Methods: From June 2020 to December 2021, a retrospective analysis was conducted on 184 consecutive AIS patients who underwent preoperative MRI and subsequent EVT at the Henan Provincial Cerebrovascular Hospital Stroke Center. Patients' medical histories were comprehensively reviewed. According to MRI, anterior circulation infarction (ACI) and posterior circulation infarction (PCI) were divided into four groups respectively (A-D & a-d). Three types (1-3) of etiology were identified based on pathogenesis. The types were respectively evaluated by screening test with intra-operative finding of EVT.

Results: Our imaging-etiologic classification achieved an overall positive rate of 90.2% (166/184) when compared to the gold standard. The screening test for each type demonstrated excellent validity (Youden's index ≥ 0.75) and reliability (Kappa ≥ 0.80).

Conclusion: The imaging-etiologic classification represents a simple yet comprehensive approach that can be readily applied in the management of AIS with LVO. It can rapidly and effectively locate the vascular occlusion, and reveal the pathogenesis.

基于核磁共振成像和发病机制,对新提出的大血管闭塞性急性缺血性脑卒中成像-病理分类进行回顾性分析。
背景:血管内治疗(EVT)已成为伴有大血管闭塞(LVO)的急性缺血性卒中(AIS)的首选初始治疗方案。为了促进更有针对性的 EVT 干预,我们提出了一个新的成像-病理分类系统,该系统源自对 AIS 患者术前 MRI 和发病机制的综合分析:方法:2020 年 6 月至 2021 年 12 月,我们对河南省脑血管病医院卒中中心连续接受术前 MRI 和随后 EVT 的 184 例 AIS 患者进行了回顾性分析。对患者的病史进行了全面回顾。根据磁共振成像,前循环梗死(ACI)和后循环梗死(PCI)分别被分为四组(A-D 和 a-d)。根据发病机制确定了三种病因类型(1-3)。这些类型分别通过筛查试验和术中发现的 EVT 进行评估:结果:与金标准相比,我们的成像病因学分类的总体阳性率达到 90.2%(166/184)。每种类型的筛查测试都表现出极佳的有效性(Youden 指数≥ 0.75)和可靠性(Kappa ≥ 0.80):成像-病理分类法是一种简单而全面的方法,可随时应用于伴有 LVO 的 AIS 的治疗。结论:成像-病因分类法是一种简单而全面的方法,可随时应用于伴有左心室积水的 AIS 的治疗中,它能快速有效地定位血管闭塞并揭示发病机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
PeerJ
PeerJ MULTIDISCIPLINARY SCIENCES-
CiteScore
4.70
自引率
3.70%
发文量
1665
审稿时长
10 weeks
期刊介绍: PeerJ is an open access peer-reviewed scientific journal covering research in the biological and medical sciences. At PeerJ, authors take out a lifetime publication plan (for as little as $99) which allows them to publish articles in the journal for free, forever. PeerJ has 5 Nobel Prize Winners on the Board; they have won several industry and media awards; and they are widely recognized as being one of the most interesting recent developments in academic publishing.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信