Impact of Ischemic Lesion Location on the mRS Score in Patients with Ischemic Stroke: A Voxel-Based Approach
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Impact of Ischemic Lesion Location on the mRS Score in Patients with Ischemic Stroke: A Voxel-Based Approach. / Ernst, M; Boers, A M M; Forkert, N D; Berkhemer, O A; Roos, Y B; Dippel, D W J; van der Lugt, A; van Oostenbrugge, R J; van Zwam, W H; Vettorazzi, E; Fiehler, J; Marquering, H A; Majoie, C B L M; Gellissen, S; MR CLEAN trial investigators (www.mrclean-trial.org).
in: AM J NEURORADIOL, Jahrgang 39, Nr. 11, 01.11.2018, S. 1989-1994.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Impact of Ischemic Lesion Location on the mRS Score in Patients with Ischemic Stroke: A Voxel-Based Approach
AU - Ernst, M
AU - Boers, A M M
AU - Forkert, N D
AU - Berkhemer, O A
AU - Roos, Y B
AU - Dippel, D W J
AU - van der Lugt, A
AU - van Oostenbrugge, R J
AU - van Zwam, W H
AU - Vettorazzi, E
AU - Fiehler, J
AU - Marquering, H A
AU - Majoie, C B L M
AU - Gellissen, S
AU - MR CLEAN trial investigators (www.mrclean-trial.org)
N1 - © 2018 by American Journal of Neuroradiology.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - BACKGROUND AND PURPOSE: Previous studies indicated that ischemic lesion volume might be a useful surrogate marker for functional outcome in ischemic stroke but should be considered in the context of lesion location. In contrast to previous studies using the ROI approach, which has several drawbacks, the present study aimed to measure the impact of ischemic lesion location on functional outcome using a more precise voxelwise approach.MATERIALS AND METHODS: Datasets of patients with acute ischemic strokes from the Multicenter Randomized Clinical Trial of Endovascular Therapy for Acute Ischemic Stroke in the Netherlands (MR CLEAN) were used. Primary outcome was functional outcome as assessed by the modified Rankin Scale 3 months after stroke. Ischemic lesion volume was determined on CT scans 3-9 days after stroke. Voxel-based lesion-symptom mapping techniques, including covariates that are known to be associated with functional outcome, were used to determine the impact of ischemic lesion location for outcome.RESULTS: Of the 500 patients in the MR CLEAN trial, 216 were included for analysis. The mean age was 63 years. Lesion-symptom mapping with inclusion of covariates revealed that especially left-hemispheric lesions in the deep periventricular white matter and adjacent internal capsule showed a great influence on functional outcome.CONCLUSIONS: Our study confirms that infarct location has an important impact on functional outcome of patients with stroke and should be considered in prediction models. After we adjusted for covariates, the left-hemispheric corticosubcortical fiber tracts seemed to be of higher functional importance compared with cortical lesions.
AB - BACKGROUND AND PURPOSE: Previous studies indicated that ischemic lesion volume might be a useful surrogate marker for functional outcome in ischemic stroke but should be considered in the context of lesion location. In contrast to previous studies using the ROI approach, which has several drawbacks, the present study aimed to measure the impact of ischemic lesion location on functional outcome using a more precise voxelwise approach.MATERIALS AND METHODS: Datasets of patients with acute ischemic strokes from the Multicenter Randomized Clinical Trial of Endovascular Therapy for Acute Ischemic Stroke in the Netherlands (MR CLEAN) were used. Primary outcome was functional outcome as assessed by the modified Rankin Scale 3 months after stroke. Ischemic lesion volume was determined on CT scans 3-9 days after stroke. Voxel-based lesion-symptom mapping techniques, including covariates that are known to be associated with functional outcome, were used to determine the impact of ischemic lesion location for outcome.RESULTS: Of the 500 patients in the MR CLEAN trial, 216 were included for analysis. The mean age was 63 years. Lesion-symptom mapping with inclusion of covariates revealed that especially left-hemispheric lesions in the deep periventricular white matter and adjacent internal capsule showed a great influence on functional outcome.CONCLUSIONS: Our study confirms that infarct location has an important impact on functional outcome of patients with stroke and should be considered in prediction models. After we adjusted for covariates, the left-hemispheric corticosubcortical fiber tracts seemed to be of higher functional importance compared with cortical lesions.
KW - Journal Article
U2 - 10.3174/ajnr.A5821
DO - 10.3174/ajnr.A5821
M3 - SCORING: Journal article
C2 - 30287456
VL - 39
SP - 1989
EP - 1994
JO - AM J NEURORADIOL
JF - AM J NEURORADIOL
SN - 0195-6108
IS - 11
ER -