Mediation of Multiphase Collateral Status on Functional Outcome by ASPECTS-Based Net Water Uptake in Acute Stroke

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging Pub Date : 2025-06-18 DOI:10.1111/jon.70045

Qiuxuan Li, Xuesong Bai, Fan Yu, Yao Lu, Miao Zhang, Jingkai Li, Yuan Li, Qiuyue Tian, Adam A. Dmytriw, Robert W. Regenhardt, Liqun Jiao, Jie Lu

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引用次数: 0

Abstract

Background and Purposes

The Alberta Stroke Program Early CT Score-based net water uptake (ASPECTS-NWU) is a quantitative imaging biomarker used to assess early ischemic changes in acute ischemic stroke patients. ASPECTS-NWU has been investigated in identifying stroke onset time, measuring ischemic tissue edema, and predicting functional outcomes. However, the mediating effect of ASPECTS-NWU and its association with collaterals, infarct volume, and functional outcome still need to be explored. Therefore, we hypothesized that ASPECTS-NWU is a mediator between collateral circulation and infarct volume and investigated their association with outcome.

Methods

There were 201 patients, and 131 of them underwent mechanical thrombectomy. Collaterals were graded using the multiphase Menon score. The mediating effect of ASPECTS-NWU between collaterals and infarct volume was investigated. The association between infarct volume, collaterals, recanalization status, and functional outcome was assessed by univariable and multivariate logistic regression analysis.

Results

Patients with good collaterals displayed higher ASPECTS, lower ASPECTS-NWU, lower National Institute of Health Stroke Scale score at admission (NIHSS_admission), and smaller infarct volume, ischemic tissue volume, and penumbra volume. ASPECTS-NWU was a mediator between collaterals and infarct volume, and the contribution rate of the mediator was 27.9%. In multivariate logistic regression analysis, infarct volume and recanalization status were associated with functional outcomes.

Conclusions

ASPECTS-NWU was a mediator and played a partial role between collaterals and infarct volume. Infarct volume and recanalization status were strong predictors of functional outcome. ASPECTS-NWU and collaterals indirectly influenced functional outcomes by regulating infarct volume.

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多相侧支状态对急性脑卒中患者净摄水量的影响

背景和目的阿尔伯塔卒中项目早期CT评分为基础的净摄水量（ASPECTS-NWU）是一种定量成像生物标志物，用于评估急性缺血性卒中患者的早期缺血性变化。ASPECTS-NWU在确定卒中发作时间、测量缺血性组织水肿和预测功能预后方面进行了研究。然而，ASPECTS-NWU的介导作用及其与络、梗死面积和功能结局的关系仍需探索。因此，我们假设ASPECTS-NWU是侧支循环和梗死体积之间的中介，并研究了它们与预后的关系。方法201例患者，其中131例行机械取栓术。使用多相Menon评分对抵押品进行评分。观察ASPECTS-NWU在络部与梗死体积之间的中介作用。通过单变量和多变量logistic回归分析评估梗死面积、侧枝、再通状态和功能结局之间的关系。结果侧络良好的患者在入院时表现出较高的ASPECTS，较低的ASPECTS- nwu，较低的美国国立卫生研究院卒中量表评分（nihss入院），较小的梗死体积、缺血组织体积和半暗区体积。ASPECTS-NWU是络部与梗死面积之间的中介，贡献率为27.9%。在多变量logistic回归分析中，梗死面积和再通状态与功能预后相关。结论spect - nwu在络支与梗死体积之间起部分中介作用。梗死面积和再通状态是功能预后的有力预测指标。ASPECTS-NWU和侧枝通过调节梗死体积间接影响功能结局。

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 Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!