Background

Cerebral oxygenation is closely related to neural function in acute ischemic stroke (AIS) and can be measured noninvasively from asymmetrically prominent cortical veins (APCVs) using quantitative susceptibility mapping (QSM).

Purpose

To quantify venous oxygen saturation (SvO₂) using brain MRI with QSM in patients with AIS, to analyze its change at 2-week follow-up, and to assess the influence of SvO₂ in clinical prognosis.

Materials and Methods

Between 2016 and 2020, consecutive patients with AIS who underwent brain MRI within 24 hours from symptom onset and 2 weeks after treatment were retrospectively enrolled. The SvO₂ of APCVs was quantified using QSM. The independent sample t test was used to compare the SvO₂ between patients with and patients without APCVs. The paired sample t test was used to assess the dynamic change in SvO₂. Pearson and Spearman correlation analysis was used to explore the relationship among dynamic change in SvO₂ and hypoperfusion, National Institutes of Health Stroke Scale (NIHSS) score change, and 90-day modified Rankin Scale (mRS) score. The independent sample t test was used to compare the dynamic change in SvO₂ between different clinical prognoses and outcome subgroups.

Results

APCVs were detected in 39 of 73 patients (mean age, 70 years ± 10 [standard deviation]; 49 men) at admission and disappeared in 35 patients at 2-week follow-up MRI. The mean SvO₂ increased from 35.0% ± 5.8 to 64.5% ± 10.0 (P < .001) in 39 patients. For the 35 patients with APCVs that disappeared, the dynamic change in SvO₂ negatively correlated with change in NIHSS score (r = –0.37, R² = 0.19, P = .03) and 90-day mRS score (r = –0.54, R² = 0.27, P = .001), and the dynamic change in SvO₂ in the subgroup with good 90-day outcomes (n = 19) was greater than that in the subgroup with poor 90-day outcomes (n = 16) (mean, 34.5% ± 5.8 vs 29.7% ± 6.3; 95% CI: 0.6, 8.9; P = .03).

Conclusion

Improved oxygen saturation of asymmetric cortical veins detected using brain MRI with quantitative susceptibility mapping corresponded with better acute ischemic stroke outcomes for patients with asymmetrically prominent cortical veins that disappeared at 2-week follow-up MRI.

© RSNA, 2021

Online supplemental material is available for this article.

中文翻译：

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不对称皮质静脉的动态变化与急性缺血性卒中的神经系统预后相关

背景

脑氧合与急性缺血性卒中 (AIS) 的神经功能密切相关，可以使用定量磁敏图 (QSM) 从不对称突出的皮质静脉 (APCV) 无创测量。

目的

使用QSM脑MRI量化AIS患者的静脉血氧饱和度（SvO ₂），分析其在2周随访时的变化，并评估SvO ₂对临床预后的影响。

材料和方法

2016 年至 2020 年期间，回顾性纳入了在症状出现后 24 小时内和治疗后 2 周内接受脑部 MRI 的连续 AIS 患者。APCV 的 SvO ₂使用 QSM 进行量化。独立样本t检验用于比较有和没有 APCV 的患者之间的 SvO ₂。配对样本t检验用于评估 SvO ₂的动态变化。采用 Pearson 和 Spearman 相关分析探讨 SvO _{2 的}动态变化与低灌注、美国国立卫生研究院卒中量表 (NIHSS) 评分变化和 90 天改良 Rankin 量表 (mRS) 评分之间的关​​系。独立样本t检验用于比较不同临床预后和结果亚组之间SvO ₂的动态变化。

结果

入院时 73 名患者中有 39 名（平均年龄，70 岁 ± 10 [标准差]；49 名男性）检测到 APCV，并在 2 周随访 MRI 时在 35 名患者中消失。39 名患者的平均 SvO ₂从 35.0% ± 5.8 增加到 64.5% ± 10.0 ( P < .001)。对于 35 名 APCV 消失的患者，SvO ₂的动态变化与 NIHSS 评分的变化（r = –0.37，R ² = 0.19，P = .03）和 90 天 mRS 评分（r = –0.54，R ² = 0.27, P = .001)，以及具有良好 90 天结果的亚组中 SvO ₂的动态变化( n= 19) 大于 90 天结局不良的亚组 ( n = 16)（平均，34.5% ± 5.8 vs 29.7% ± 6.3；95% CI：0.6, 8.9；P = .03）。

结论

对于在 2 周随访 MRI 中消失的不对称突出皮质静脉的患者，使用脑 MRI 检测到的非对称皮质静脉氧饱和度的改善与定量磁化率映射相对应。

©北美放射学会，2021

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