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Yang Y, He Y, Xu Y, Han W, Shao Y, Zhao T, Yu M. The impact of asymptomatic intracranial atherosclerotic stenosis on the clinical outcomes of patients with single subcortical infarction. Front Med (Lausanne) 2023; 10:1249347. [PMID: 37720506 PMCID: PMC10502720 DOI: 10.3389/fmed.2023.1249347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Background The presence of parental arterial disease (PAD) is correlated with the outcomes of patients with a single subcortical infarction (SSI). Due to the relatively low incidence of PAD, the predictors of outcomes seem to be limited for SSI patients without PAD. This study aims to investigate the association between asymptomatic intracranial atherosclerotic stenosis (aIAS) and outcomes in patients with SSI and in the subgroup without PAD. Methods Patients with SSI were consecutively enrolled. aIAS referred to a stenosis of ≥50% in intracranial arteries irrelevant to SSI by using magnetic resonance angiography. A poor outcome refers to a modified Ranking Scale >2 points at discharge. Results In total, 298 participants were enrolled. The presence of aIAS could predict a poor outcome for all SSI patients [adjusted relative risk (aRR) = 2.14, 95% confidence interval (CI) = 1.17-3.93, p = 0.014] and in the subgroup without PAD (aRR = 3.12, 95% CI = 1.47-6.62, p = 0.003), but not in the subgroup with PAD. Compared with participants with neither aIAS nor PAD, the risk of a poor outcome increased approximately 2-fold in those with aIAS only (aRR = 2.95, 95% CI = 1.55-5.60, p = 0.001) and in those with concomitant aIAS and PAD (aRR = 3.10, 95% CI = 1.62-5.95, p = 0.001). Conclusion The presence of aIAS is a predictor of a poor outcome in SSI patients, especially in those without PAD.
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Affiliation(s)
- Yi Yang
- Department of Neurology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Yue He
- Department of Neurology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Yuhao Xu
- Department of Neurology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Wei Han
- Department of Neurology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Yuanwei Shao
- Department of Radiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Tian Zhao
- Department of Radiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Ming Yu
- Department of Neurology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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2
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Yang Y, He Y, Xu Y, Han W, Zhao T, Shao Y, Yu M. Poststroke neutrophil count is predictive of the outcomes of large-artery atherosclerotic stroke and associated with craniocervical atherosclerosis. Sci Rep 2023; 13:11486. [PMID: 37460533 DOI: 10.1038/s41598-023-37815-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/28/2023] [Indexed: 07/20/2023] Open
Abstract
Elevation of the neutrophil count is detrimental to the outcome of patients with stroke. The effect of poststroke neutrophil count on the outcome of patients with large-artery atherosclerosis (LAA) stroke is unclear. This study aims to explore the relationship of poststroke neutrophil count with the functional outcome of patients with LAA stroke, and the relationship of poststroke neutrophil count and craniocervical atherosclerotic stenosis (AS) number in these patients. The AS was defined as ≥ 50% stenosis or occlusion attributed to atherosclerosis on craniocervical large arteries. A total of 297 participants were enrolled in the cohort. In multivariable analyses, neutrophil count [adjusted relative risk (aRR) = 1.23, 95% confidence interval (CI) 1.09-1.40, p = 0.001] was an independent predictor of 90-day poor functional outcome [modified Rankin Scale (mRS) > 2 points]. The neutrophil count was significantly associated with the craniocervical AS number in a multivariable ordinal logistic regression analysis [adjusted odds ratio (aOR) = 1.41, 95% CI 1.16-1.72, p = 0.001]. The poststroke neutrophil count is a valuable predictor of 90-day poor functional outcome of patients with LAA stroke. The poststroke neutrophil count is positively correlated with the craniocervical AS number in these patients.
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Affiliation(s)
- Yi Yang
- Department of Neurology, Affiliated Hospital of Jiangsu University, Jiangsu University, No.438 Jiefang Street, Zhenjiang, Jiangsu, China
| | - Yue He
- Department of Neurology, Affiliated Hospital of Jiangsu University, Jiangsu University, No.438 Jiefang Street, Zhenjiang, Jiangsu, China
| | - Yuhao Xu
- Department of Neurology, Affiliated Hospital of Jiangsu University, Jiangsu University, No.438 Jiefang Street, Zhenjiang, Jiangsu, China
| | - Wei Han
- Department of Neurology, Affiliated Hospital of Jiangsu University, Jiangsu University, No.438 Jiefang Street, Zhenjiang, Jiangsu, China
| | - Tian Zhao
- Department of Radiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Yuanwei Shao
- Department of Radiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Ming Yu
- Department of Neurology, Affiliated Hospital of Jiangsu University, Jiangsu University, No.438 Jiefang Street, Zhenjiang, Jiangsu, China.
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3
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Shen GC, Chu Y, Ma G, Xu XQ, Lu SS, Shi HB, Wu FY. Use of ABC/2 method for rapidly estimating the target mismatch on computed tomography perfusion imaging in patients with acute ischemic stroke. Acta Radiol 2021; 64:320-327. [PMID: 34970928 DOI: 10.1177/02841851211069778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Target mismatch (ischemic core, mismatch volume and mismatch ratio) in patients with acute ischemic stroke (AIS) highly relies on the automated perfusion analysis software. PURPOSE To evaluate the feasibility and accuracy of using the ABC/2 method to rapidly estimate the target mismatch on computed tomography perfusion (CTP) imaging in patients with AIS, using RAPID results as a reference. MATERIAL AND METHODS In total, 243 patients with anterior circulation AIS who underwent CTP imaging were retrospectively reviewed. Target mismatch associated perfusion parameters were derived from RAPID results and calculated using the ABC/2 method. Paired t-test was used to assess the difference of volumetric parameters between the two methods. The ability of using the ABC/2 method to predict the important cutoff volumetric metrics was also evaluated. RESULT There was no significant difference in the volumes of ischemic core (P = 0.068), ischemic area (P = 0.209), and mismatch volume (P = 0.518) between ABC/2 and RAPID. Using RAPID results as reference, the ABC/2 method showed high accuracy for predicting perfusion parameters (70 mL and 90 mL: sensitivity=98.5% and 98.5%, specificity=100% and 100%, positive predictive value [PPV]=100% and 100%, negative predictive value [NPV]=93.8% and 92.9%; 10 mL and 15mL: sensitivity=99.6% and 99.5%, specificity=55.6% and 50.0%, PPV=96.6% and 94.8%, NPV=90.9% and 92.3%; 1.2 and 1.8: sensitivity=99.6% and 94.8%, specificity=75.0% and 96.9%, PPV=98.7% and 99.5%, NPV=90.0% and 73.8%). CONCLUSION The ABC/2 method may be a feasible alternative to RAPID for estimation of target mismatch parameters on CTP in patients with AIS.
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Affiliation(s)
- Guang-Chen Shen
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yue Chu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Gao Ma
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xiao-Quan Xu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Shan-Shan Lu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hai-Bin Shi
- Department of Interventional Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Fei-Yun Wu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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Zeiger WA, Marosi M, Saggi S, Noble N, Samad I, Portera-Cailliau C. Barrel cortex plasticity after photothrombotic stroke involves potentiating responses of pre-existing circuits but not functional remapping to new circuits. Nat Commun 2021; 12:3972. [PMID: 34172735 PMCID: PMC8233353 DOI: 10.1038/s41467-021-24211-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 06/01/2021] [Indexed: 01/14/2023] Open
Abstract
Recovery after stroke is thought to be mediated by adaptive circuit plasticity, whereby surviving neurons assume the roles of those that died. However, definitive longitudinal evidence of neurons changing their response selectivity after stroke is lacking. We sought to directly test whether such functional “remapping” occurs within mouse primary somatosensory cortex after a stroke that destroys the C1 barrel. Using in vivo calcium imaging to longitudinally record sensory-evoked activity under light anesthesia, we did not find any increase in the number of C1 whisker-responsive neurons in the adjacent, spared D3 barrel after stroke. To promote plasticity after stroke, we also plucked all whiskers except C1 (forced use therapy). This led to an increase in the reliability of sensory-evoked responses in C1 whisker-responsive neurons but did not increase the number of C1 whisker-responsive neurons in spared surround barrels over baseline levels. Our results argue against remapping of functionality after barrel cortex stroke, but support a circuit-based mechanism for how rehabilitation may improve recovery. Definitive evidence for functional remapping after stroke remains lacking. Here, the authors performed in vivo intrinsic signal imaging and two-photon calcium imaging of sensory-evoked responses before and after photothrombotic stroke and found no evidence of remapping of lost functionalities to new circuits in peri-infarct cortex.
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Affiliation(s)
- William A Zeiger
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
| | - Máté Marosi
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX, USA
| | - Satvir Saggi
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Natalie Noble
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Isa Samad
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Carlos Portera-Cailliau
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. .,Department of Neurobiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
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5
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Lu D, Hu M, Zhang B, Lin Y, Zhu Q, Men X, Lu Z, Cai W. Temporal and Spatial Dynamics of Inflammasome Activation After Ischemic Stroke. Front Neurol 2021; 12:621555. [PMID: 33967935 PMCID: PMC8104123 DOI: 10.3389/fneur.2021.621555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/15/2021] [Indexed: 12/16/2022] Open
Abstract
Background: The inflammasome represents a highly pro-inflammatory mechanism. It has been identified that inflammasome was activated after ischemic stroke. However, the impact of inflammasomes on stroke outcomes remains contradictory. The participating molecules and the functioning arena of post-stroke inflammasome activation are still elusive. Methods: In the present study, blood samples from stroke patients were collected and analyzed with flow cytometry to evaluate the correlation of inflammasome activation and stroke outcomes. A stroke model was established using male C57/Bl6 mice with transient middle cerebral artery occlusion (tMCAO, 1 h). The dynamics of inflammasome components, cell type, and location of inflammasome activation and the therapeutic effects of inhibiting post-stroke inflammasome executors were evaluated. Results: We found that a high level of inflammasome activation might indicate detrimental stroke outcomes in patients and mice models. Post-stroke inflammasome activation, especially NLRP3, cleaved Caspase-1, cleaved Caspase-11, IL-1β, IL-18, and GSDMD, peaked at 3–5 days and declined at 7 days with the participation of multiple components in mice. Macrophage that infiltrated into the ischemic lesion was the main arena for post-stroke inflammasome activation among myeloid cells according to the data of mice. Among all the members of the Caspase family, Caspase-1 and −11 served as the main executing enzymes. Inhibiting Caspase-1/−11 signaling efficiently suppressed DAMPs-induced macrophage inflammasome activation and displayed neuroprotection to stroke models including infarct size (Control: 48.05 ± 14.98; Cas1.i: 19.34 ± 12.21; Cas11.i: 21.43 ± 14.67, P < 0.001) and neurological deficit score (0 d-Control: 2.20 ± 0.63; 0 d-Cas1.i: 2.20 ± 0.63; 0 d-Cas11.i: 2.20 ± 0.63; 1 d-Control: 2.50 ± 0.53; 1 d-Cas1.i: 1.50 ± 0.71; 1 d-Cas11.i: 2.00 ± 0.67; 2 d-Control: 2.30 ± 0.48; 2 d-Cas1.i: 1.30 ± 0.48; 2 d-Cas11.i: 1.50 ± 0.53; 3 d-Control: 2.00 ± 0.67; 3 d-Cas1.i: 1.20 ± 0.42; 3 d-Cas11.i: 1.30 ± 0.48, P < 0.001). Conclusions: Taken together, inflammasome activation played a detrimental role in stroke pathology. Targeting post-stroke inflammasome executing enzymes fitting in the dynamics of macrophages might obtain potential and efficient therapeutic effects.
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Affiliation(s)
- Danli Lu
- Department of Neurology, Mental and Neurological Disease Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Mengyan Hu
- Department of Neurology, Mental and Neurological Disease Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Bingjun Zhang
- Department of Neurology, Mental and Neurological Disease Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yinyao Lin
- Department of Neurology, Mental and Neurological Disease Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qiang Zhu
- Department of Neurology, Mental and Neurological Disease Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xuejiao Men
- Department of Neurology, Mental and Neurological Disease Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhengqi Lu
- Department of Neurology, Mental and Neurological Disease Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wei Cai
- Department of Neurology, Mental and Neurological Disease Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Center of Clinical Immunology, Mental and Neurological Disease Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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6
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Cheng X, Liu Q, Shi J, Zhou C, Su X, Dong Z, Xing W, Lu H, Pan C, Li X, Yu Y, Lu G. Reliability and Reproducibility of the Diameters Method in Rapid Determination of Acute Infarct Volume in Magnetic Resonance Diffusion-Weighted Imaging. Cerebrovasc Dis 2020; 49:575-582. [DOI: 10.1159/000509072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/02/2020] [Indexed: 11/19/2022] Open
Abstract
<b><i>Background:</i></b> In acute ischemic stroke, diffusion-weighted imaging (DWI) volume is an independent predictive factor of poor outcome and an exclusion criterion for thrombolytic treatment. A simplified diameters method (ABC/2, orthogonal diameter [OD], and the maximum diameter [MD]) was proposed to replace the conventional measuring method and overcome the tedious and time-consuming defects, but its accuracy remains to be determined. <b><i>Objective:</i></b> The objective of this study is to clarify the reliability and reproducibility of the diameter-based estimations in the infarct volume in DWI (Vol-DWI) measured by automated software. <b><i>Methods:</i></b> Data of 316 patients with acute ischemic stroke who underwent MRI within 72 h at Jinling Hospital were retrospectively reviewed. Subgroup analysis by the location (cortex, white matter and deep gray nuclei, and combined) and volume (<70 and >70 mL) of cerebral infarction was evaluated. Relationship and consistency between the diameters methods and Vol-DWI were determined using Spearman rank correlation, Wilcoxon signed-rank test, and Bland-Altman plots. The OD and MD thresholds indicating infarct size >15, 70, and 100 mL were determined by generating receiver-operating characteristic (ROC) curves. Interobserver reliability was established using intraclass correlation coefficient and Bland-Altman plot. <b><i>Results:</i></b> There was a strong positive correlation between the diameters and the Vol-DWI (ABC/2: <i>r</i> = 0.992, OD: <i>r</i> = 0.984, MD: <i>r</i> = 0.970, <i>p</i> < 0.001). Infarct volumes measured using the ABC/2 formula were significantly lower than those measured with Vol-DWI (Wilcoxon signed-rank test, <i>z</i> = 6.476, <i>p</i> < 0.001). Bland-Altman plot showed that the agreement of the volume <70 mL group, and white matter and deep gray nuclei groups was better than that of the other subgroups. For infarct volumes >15, 70, and 100 mL, the cutoff value for the MD was identified at 5, 6.9, and 8.4 cm, and the OD was identified at 12.47, 26.4, and 36.4 cm<sup>2</sup>, respectively, with a sensitivity and specificity >90%. <b><i>Conclusions:</i></b> The MD method was the best for achieving a rapid and excellent interobserver reliability for estimating infarct volume. Both OD and MD methods can quickly screen patients suitable for recanalization treatment and predict poor prognosis through threshold evaluation.
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7
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Kufner A, Stief J, Siegerink B, Nolte C, Endres M, Fiebach JB. Two simple and rapid methods based on maximum diameter accurately estimate large lesion volumes in acute stroke. Brain Behav 2020; 10:e01828. [PMID: 32909402 PMCID: PMC7667359 DOI: 10.1002/brb3.1828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 07/10/2020] [Accepted: 07/19/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We compared two simple and rapid diameter-based methods (ABC/2, od-value) in terms of their accuracy in predicting lesion volume >70 ml and >100 ml. METHODS In 238 DWI images of ischemic stroke patients from the AXIS2 trial, maximum lesion diameter and corresponding maximum orthogonal diameter were measured. Estimation of infarct volume based on od-value and ABC/2 calculation was compared to volumetric assessments. RESULTS Accuracy of od-value and ABC/2 was similar for >70 ml (92.0 vs. 87.4) and >100 ml (92.9 vs. 93.3). ABC/2 overestimated lesion volume by 29.9%, resulting in a lower specificity. CONCLUSIONS Od-value is a robust tool for patient selection in trials.
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Affiliation(s)
- Anna Kufner
- Department of Neurology, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Jonas Stief
- Department of Radiology, Charité - Universitätsmedizin, Berlin, Germany
| | - Bob Siegerink
- Department of Neurology, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Christian Nolte
- Department of Neurology, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin, Berlin, Germany
| | - Matthias Endres
- Department of Neurology, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Jochen B Fiebach
- Department of Neurology, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin, Berlin, Germany
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8
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Yuan T, Ren G, Quan G, Liu Y. Maximum lesions area and orthogonal values accessed from DWI images would be alternative imaging markers for predicting the outcome of acute ischemia in the middle cerebral artery territory. Acta Radiol 2019; 60:628-633. [PMID: 30130971 DOI: 10.1177/0284185118795330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Evaluating the acute ischemic volume on diffusion-weighted imaging (DWI) in the middle cerebral artery (MCA) territory would predict outcome. PURPOSE To investigate the correlations between maximum area with restricted diffusion (MaxA), the orthogonal diameters (OD) as well as lesion volume on DWI, and to explore the role of MaxA and OD on predicting unfavorable outcome after an acute MCA ischemic stroke. MATERIAL AND METHODS Sixty consecutive adult patients, including modified Rankin Scale score (mRS) ≤2 (n = 31) and mRS > 2 (n = 29) groups, were retrospectively enrolled. The MaxA and OD of lesions were assessed at the slice containing the largest infarction size on DWI images. We compared the prediction efficiencies of these methods on unfavorable outcomes. RESULTS The correlation coefficients between the MaxA and infarction volume and OD and infarction volume were 0.982 ( P < 0.001) and 0.952 ( P < 0.001), respectively. The times required for measuring MaxA (150 s [130-160]) and OD (30 s [20-60]) were much shorter than that for infarction volume measurement (1240 s [180-1480]) ( P = 0.001, P = 0.004). With thresholds of ≥57.3 mL for infarction volume, ≥15.2 cm2 for MaxA, and ≥38.1 for the arithmetic product of OD, the AUCs of infarction volume, MaxA, and OD for predicting an unfavorable outcome were 0.818, 0.821, and 0.820, respectively. CONCLUSION Since they correlated well with the infarction volume, MaxA and OD assessed on DWI were time-saving and achieved comparable diagnostic efficiencies; thus, they may represent alternative imaging markers for predicting unfavorable outcomes of acute ischemic stroke in MCA territory.
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Affiliation(s)
- Tao Yuan
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, PR China
| | - Guoli Ren
- Department of Medical Imaging, Liaocheng People’s Hospital, Liaocheng, PR China
| | - Guanmin Quan
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, PR China
| | - Yawu Liu
- Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
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Functional Dynamics of Neutrophils After Ischemic Stroke. Transl Stroke Res 2019; 11:108-121. [PMID: 30847778 DOI: 10.1007/s12975-019-00694-y] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 02/11/2019] [Accepted: 02/13/2019] [Indexed: 12/27/2022]
Abstract
Neutrophils are forerunners to brain lesions after ischemic stroke and exert elaborate functions. However, temporal alterations of cell count, polarity, extracellular trap formation, and clearance of neutrophils remain poorly understood. The current study was aimed at providing basic information of neutrophil function throughout a time course following stroke onset in patients and animal subjects. We found that neutrophil constitution in peripheral blood increased soon after stroke onset of patients, and higher neutrophil count indicated detrimental stroke outcomes. Comparably, neutrophil count in peripheral blood of stroke mice peaked at 12 h after cerebral ischemia, followed by a 1-2-day spike in brain lesions. In stroke lesion, clearance of neutrophils peaked at 2 days after stroke and extracellular traps were mostly detected at 2-3 days after stroke. In neutrophil infiltrated into stroke lesion, expression of the N2 marker CD206 was relatively stable. We found that the N2 phenotype facilitated neutrophil clearance by macrophage and did not further induce neuronal death after ischemic injury compared with N0 or N1 neutrophils. Skewing neutrophil toward the N2 phenotype before stroke reduced infarct volumes at 1 day after tMCAO. Conditioned medium of ischemic neurons drove neutrophils away from the protective N2 phenotype and increased the formation of extracellular traps. Conclusively, neutrophil function has an important impact on stroke outcomes. Neutrophil frequency in the peripheral blood could be an early indicator of stroke outcomes. N2 neutrophils facilitate macrophage phagocytosis and are less harmful to ischemic neurons. Directing neutrophils toward the N2 phenotype could be a promising therapeutic approach for ischemic stroke.
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10
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Galinovic I, Dicken V, Heitz J, Klein J, Puig J, Guibernau J, Kemmling A, Gellissen S, Villringer K, Neeb L, Gregori J, Weiler F, Pedraza S, Thomalla G, Fiehler J, Gerloff C, Fiebach JB. Homogeneous application of imaging criteria in a multicenter trial supported by investigator training: A report from the WAKE-UP study. Eur J Radiol 2018; 104:115-119. [DOI: 10.1016/j.ejrad.2018.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 03/27/2018] [Accepted: 05/10/2018] [Indexed: 10/16/2022]
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11
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Takahashi Y, Yamashita T, Morihara R, Nakano Y, Sato K, Takemoto M, Hishikawa N, Ohta Y, Manabe Y, Abe K. Different Characteristics of Anterior and Posterior Branch Atheromatous Diseases with or without Early Neurologic Deterioration. J Stroke Cerebrovasc Dis 2017; 26:1314-1320. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/22/2017] [Accepted: 02/02/2017] [Indexed: 11/25/2022] Open
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12
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Gawlitza M, Fiedler E, Schob S, Hoffmann KT, Surov A. Peritumoral Brain Edema in Meningiomas Depends on Aquaporin-4 Expression and Not on Tumor Grade, Tumor Volume, Cell Count, or Ki-67 Labeling Index. Mol Imaging Biol 2016; 19:298-304. [DOI: 10.1007/s11307-016-1000-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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