Work

Amide proton transfer MRI may reflect effective reperfusion and predict functional outcomes in patients with ischemic stroke

Year: 2024

Type: article

Abstract: Perfusion imaging is useful to assess tissue recovery in patients with acute ischemic stroke (AIS); however, it cannot reflect tissue metabolism. We postulated that amide proton transfer (APT) imaging can characterize the tissue status after reperfusion therapy, thus providing prognostic value for 90-day functional outcomes. We included 63 patients with AIS and large-vessel occlusion (LVO). The APT signals, including APT # and NOE # (nuclear Overhauser enhancement) were quantified. Ischemic lesions observed on APT # and diffusion-weighted imaging (DWI) were classified according to their mismatch patterns (APT # < DWI; APT # ≥ DWI). Predictors of 90-day good outcomes (modified Rankin scale score 0–2) were evaluated. Patients with successful reperfusion exhibited higher APT # , smaller percentage change of APT # , and a greater likelihood of presenting APT # < DWI compared to those with poor reperfusion (all P < 0.05). The APT # (odds ratio [OR] = 11.48, P = 0.046) and a mismatch pattern of APT # < DWI (OR = 7.41, P = 0.020) independently predicted good outcomes besides the clinical parameters. A mismatch pattern of APT # ≥ DWI was a significant marker of poor outcomes despite successful reperfusion ( P = 0.002). Our study provides preliminary evidence that APT may reveal tissue recovery after reperfusion and predict good outcomes at 90 days in patients with AIS and LVO.

Source: Journal of Cerebral Blood Flow & Metabolism

DOI: 10.1177/0271678x241297110