Dataset Information

Focal T2 and FLAIR hyperintensities within the infarcted area: A suitable marker for patient selection for treatment?

ABSTRACT:

Background and purpose

Some authors use FLAIR imaging to select patients for stroke treatment. However, the effect of hyperintensity on FLAIR images on outcome and bleeding has been addressed in only few studies with conflicting results.

Methods

466 patients with anterior circulation strokes were included in this study. They all were examined with MRI before intravenous or endovascular treatment. Baseline data and 3 months outcome were recorded prospectively. Focal T2 and FLAIR hyperintensities within the ischemic lesion were evaluated by two raters, and the PROACT II classification was applied to assess bleeding complications on follow up imaging. Logistic regression analysis was used to determine predictors of bleeding complications and outcome and to analyze the influence of T2 or FLAIR hyperintensity on outcome.

Results

Focal hyperintensities were found in 142 of 307 (46.3%) patients with T2 weighted imaging and in 89 of 159 (56%) patients with FLAIR imaging. Hyperintensity in the basal ganglia, especially in the lentiform nucleus, on T2 weighted imaging was the only independent predictor of any bleeding after reperfusion treatment (33.8% in patients with vs. 18.2% in those without; p = 0.003) and there was a non-significant trend for more bleedings in patients with FLAIR hyperintensity within the basal ganglia (p = 0.069). However, there was no association of hyperintensity on T2 weighted or FLAIR images and symptomatic bleeding or worse outcome.

Conclusion

Our results question the assumption that T2 or FLAIR hyperintensities within the ischemic lesion should be used to exclude patients from reperfusion therapy, especially not from endovascular treatment.

SUBMITTER: Meisterernst J

PROVIDER: S-EPMC5619762 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Focal T2 and FLAIR hyperintensities within the infarcted area: A suitable marker for patient selection for treatment?

Meisterernst Julia J Klinger-Gratz Pascal P PP Leidolt Lars L Lang Matthias F MF Schroth Gerhard G Mordasini Pasquale P Heldner Mirjam R MR Mono Marie-Luise ML Kurmann Rebekka R Buehlmann Monika M Fischer Urs U Arnold Marcel M Gralla Jan J Mattle Heinrich P HP El-Koussy Marwan M Jung Simon S

PloS one 20170928 9

<h4>Background and purpose</h4>Some authors use FLAIR imaging to select patients for stroke treatment. However, the effect of hyperintensity on FLAIR images on outcome and bleeding has been addressed in only few studies with conflicting results.<h4>Methods</h4>466 patients with anterior circulation strokes were included in this study. They all were examined with MRI before intravenous or endovascular treatment. Baseline data and 3 months outcome were recorded prospectively. Focal T2 and FLAIR hy ...[more]

PMID: 28957339

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Dataset Information

Focal T2 and FLAIR hyperintensities within the infarcted area: A suitable marker for patient selection for treatment?

Background and purpose

Methods

Results

Conclusion

Publications

Focal T2 and FLAIR hyperintensities within the infarcted area: A suitable marker for patient selection for treatment?

Similar Datasets

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