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Figures
- FIG 1.
The tissue at risk (penumbra) in admission CT perfusion imaging (maps generated by RAPID software) was co-registered to MR imaging, including the DTI sequence, within 3 days after MT of acute occlusions of the anterior circulation. Penumbra was classified in ischemic infarction, segmented in DWI, and salvaged gray matter, which was further analyzed in respect to microstructural changes by calculation of the MD index in DTI (illustrations made by Mango [ric.uthscsa.edu/mango] and 3DSlicer [slicer.org]) (Reproduced with permission from Springer Nature https://doi.org/10.1007/s00062-019-00826-9).
- FIG 2.
Graphs show the association of microstructural changes (measured by the MD index) with clinical outcome for all the patients who were completely recanalized. The MD index residuals (corrected for age, sex, time between recanalization and MR imaging, reperfusion time, admission infarct core) are negatively correlated to the NIHSS score at the time of MR imaging and positively correlated to percentage improvement of the NIHSS score between admission and the time of MR imaging.
- FIG 3.
Imaging parameters, such as infarction growth and gray matter integrity of the saved tissue (measured by the MD index of the DTI within 3 days after MT of acute occlusions of the anterior circulation), significantly mediate the effect of reperfusion success (measured by mTICI) on the clinical presentation (measured by percentage improvement of the NIHSS score); the covariates age, sex, and time between recanalization and MR imaging showed no significant influence in the analysis (Reproduced with permission from Springer Nature https://doi.org/10.1007/s00062-019-00826-9).
Tables
Basic demographic, clinical, and interventional data as well as the volume of infarction, admission infarct core, and infarction growth of the final study cohort
Patient Characteristics N = 65 Age, median (IQR), y 75 (63–83) Males/females, n (%) 31 (48)/34 (52) Interventional parameters (time), median (IQR) Groin puncture to recanalization, min 26 (20–41) Symptom onset to recanalization, min 199 (144–310) No. maneuvers 1 (1–2.5) mTICI score, n 0 2 2a 2 2b 22 3 39 Additional IV thrombolysis, n 27 NIHSS score, median (IQR) Pretreatment 12 (6–17) Time of MR imaging acquisition 2 (0–5) Percentage improvement pretreatment to time of MR imaging 0.8 (0.49–1) Modified Rankin Scale (after 90 days) (n = 52) 0–2 33 >2 19 Time between recanalization and MR imaging acquisition, median (IQR), days 3 (3–4) Volume of infarction, mean ± SD, mL 28.8 ± 48.8 Admission infarct core, mean ± SD, mL 14.3 ± 24.9 Infarction growth, mean ± SD, mL 16.9 ± 34.6
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