Abstract
To explore the capability of the amide-proton-transfer weighted (APTW) magnetic resonance imaging (MRI) in the evaluation of clinical neurological deficit at the time of hospitalization and assessment of long-term daily functional outcome for patients with acute ischemic stroke (AIS). We recruited 55 AIS patients with brain MRI acquired within 24–48 h of symptom onset and followed up with their 90-day modified Rankin Scale (mRS) score. APT weighted MRI was performed for all the study subjects to measure APTW signal quantitatively in the acute ischemic area (APTWipsi) and the contralateral side (APTWcont). Change of the APT signal between the acute ischemic region and the contralateral side (ΔAPTW) was calculated. Maximum APTW signal (APTWmax) and minimal APTW signal (APTWmin) were also acquired to demonstrate APTW signals heterogeneity (APTWmax−min). In addition, all the patients were divided into 2 groups according to their 90-day mRS score (good prognosis group with mRS score <2 and poor prognosis group with mRS score ≥2). In the meantime, ΔAPTW of these groups was compared. We found that ΔAPTW was in good correlation with National Institutes of Health Stroke Scale (NIHSS) score (R2 = 0.578, p < 0.001) and 90-day mRS score (R2 = 0.55, p < 0.001). There was significant difference of ΔAPTW between patients with good prognosis and patients with poor prognosis. Plus, APTWmax−min was significantly different between two groups. These results suggested that APT weighted MRI could be used as an effective tool to assess the stroke severity and prognosis for patients with AIS, with APTW signal heterogeneity as a possible biomarker.
Highlights
As a promising contrast mechanism, chemical exchange saturation transfer (CEST) has become an important tool in the field of molecular imaging [1]
We would like to testify the capability of amide-proton-transfer weighted (APTW) magnetic resonance imaging (MRI) as a tool to assess stroke severity as well as to predict clinical outcome of patient of acute ischemic stroke (AIS) with symptom onset between 24 and 48 h by measuring the change of APTW signal intensity
We used APTW MRI to investigate the relationship between the change of the APTW signal intensity in AIS patients and their National Institutes of Health Stroke Scale (NIHSS) score as well as their 90-day modified Rankin Scale (mRS) score
Summary
As a promising contrast mechanism, chemical exchange saturation transfer (CEST) has become an important tool in the field of molecular imaging [1]. APTW-MRI to Predict AIS Prognosis researches, the induced stroke studies were carried out under highly controlled environment and the animals were scanned during early stage of stroke within hours. Under this circumstance, the APTW imaging was called pH-weighted imaging since pH was the major factor to affect the APTW signal intensity, accounting for more than 90% [5]. We would like to testify the capability of APTW MRI as a tool to assess stroke severity as well as to predict clinical outcome of patient of acute ischemic stroke (AIS) with symptom onset between 24 and 48 h by measuring the change of APTW signal intensity
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