Prognostic Value of Adding Magnetic Resonance Imaging to Computed Tomography in Acute Ischemic Stroke.

IF 1.2 4区医学 Q3 ACOUSTICS

Journal of Clinical Ultrasound Pub Date : 2025-04-15 DOI:10.1002/jcu.23998

Kaixiang Chen, Jiafeng Ni, Bo Yin

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引用次数: 0

Abstract

Objective: To assess if magnetic resonance imaging (MRI) provides additional benefits over computed tomography (CT) in patients with acute ischemic stroke (AIS).

Methods: We retrospectively reviewed adult AIS patients who underwent an initial CT scan and received intravenous thrombolysis using rt-PA, dividing them into two groups: MRI plus CT and CT alone. Propensity-score matching (PSM) analysis was employed to reduce confounding biases.

Results: After PSM, two matched groups (168 pairs, n = 336 patients) were generated. There were no significant differences in the modified Rankin Scale (mRS) scores of 0-2 or 0-1 at 3 months between the two groups (both p > 0.05). Patients in the MRI plus CT group had significantly lower incidence rates of 7-day mortality (3.0% vs. 8.9%, p = 0.04), 30-day mortality (11.3% vs. 21.4%, p = 0.02), and symptomatic intracranial hemorrhage (SICH, 11.9% vs. 23.2%, p = 0.01). Multivariate logistic regression showed that the MRI plus CT-based regimen significantly reduced the risks of 7-day (OR = 0.02, 95% CI: 0.01-0.18; p < 0.01) and 30-day mortality (OR = 0.03, 95% CI: 0.01-0.13; p < 0.01), as well as SICH (OR = 0.27, 95% CI: 0.09-0.76; p = 0.01).

Conclusion: The addition of MRI to CT enhances prognostic value in AIS patients, as it is associated with significantly reduced risks of mortality and SICH.

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计算机断层扫描加磁共振对急性缺血性脑卒中的预后价值。

目的：评估磁共振成像（MRI）是否在急性缺血性卒中（AIS）患者中提供比计算机断层扫描（CT）更多的益处。方法：我们回顾性分析了接受初始CT扫描和rt-PA静脉溶栓治疗的成年AIS患者，将其分为两组：MRI + CT和单独CT。采用倾向分数匹配（PSM）分析来减少混杂偏差。结果：经PSM后，共生成两组配对组（168对，n = 336例）。两组患者3个月时改良Rankin量表（mRS） 0-2分、0-1分评分比较，差异均无统计学意义（p < 0.05）。MRI + CT组患者7天死亡率（3.0% vs. 8.9%, p = 0.04）、30天死亡率（11.3% vs. 21.4%, p = 0.02）和症状性颅内出血（SICH, 11.9% vs. 23.2%, p = 0.01）的发生率均显著降低。多因素logistic回归显示，MRI + ct方案显著降低了7天的风险(OR = 0.02, 95% CI: 0.01-0.18；结论：在CT基础上增加MRI检查可显著降低AIS患者的死亡率和SICH风险，从而提高其预后价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Ultrasound 医学-核医学

CiteScore

1.90

自引率

0.00%

发文量

248

审稿时长

6 months

期刊介绍： The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography. The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents. JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.