Evidence map›Paper›PMID 38507075›Full record

ArticleJournal of neurology2024

Follow-up infarct volume on fluid attenuated inversion recovery (FLAIR) imaging in distal medium vessel occlusions: the role of cerebral blood volume index.

Hamza Salim, Dhairya A Lakhani, Aneri Balar, Basel Musmar, Nimer Adeeb, Meisam Hoseinyazdi, Licia Luna, Francis Deng, Nathan Z Hyson, Janet Mei and 11 more

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed.

  1. Observational
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  6. Hypoperfusion intensity ratio is associated with follow-up infarct volume in medium vessel occlusions: A multicenter multinational study.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
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  10. Perfusion imaging parameters predict long-term clinical outcome in isolated posterior cerebral artery occlusion stroke patients.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Hamza SalimDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Dhairya A LakhaniDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Aneri BalarDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Basel MusmarDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Baton Rouge, LA, USA.
Nimer AdeebDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Baton Rouge, LA, USA.
Meisam HoseinyazdiDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Licia LunaDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Francis DengDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Nathan Z HysonDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Janet MeiDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Adam A DmytriwNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Adrien GuenegoDepartment of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium.
Tobias D FaizyDepartment of Radiology, Neuroendovascular Program, University Medical Center, Münster, Germany.
Jeremy J HeitDepartment of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA.
Gregory W AlbersDepartment of Neurology, Stanford Medical Center, Palo Alto, CA, USA.
Victor C UrrutiaDepartment of Neurology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Raf LlinasDepartment of Neurology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Elisabeth B MarshDepartment of Neurology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Argye E HillisDepartment of Neurology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Kambiz NaelUniversity of California San Francisco, San Francisco, CA, USA.
Vivek YedavalliDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA. vyedava1@jhmi.edu.ORCID http://orcid.org/0000-0002-2450-4014

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDistal medium vessel occlusions (DMVOs) contribute substantially to the incidence of acute ischemic strokes (AIS) and pose distinct challenges in clinical management and prognosis. Neuroimaging techniques, such as Fluid Attenuation Inversion Recovery (FLAIR) imaging and cerebral blood volume (CBV) index derived from perfusion imaging, have significantly improved our ability to assess the impact of strokes and predict their outcomes. The primary objective of this study was to investigate relationship between follow-up infarct volume (FIV) as assessed by FLAIR imaging in patients with DMVOs.

methodsThis prospectively collected, retrospective reviewed cohort study included patients from two comprehensive stroke centers within the Johns Hopkins Medical Enterprise, spanning August 2018-October 2022. The cohort consisted of adults with AIS attributable to DMVO. Detailed imaging analyses were conducted, encompassing non-contrast CT, CT angiography (CTA), CT perfusion (CTP), and FLAIR imaging. Univariable and multivariable linear regression models were employed to assess the association between different factors and FIV.

resultsThe study included 79 patients with DMVO stroke with a median age of 69 years (IQR, 62-77 years), and 57% (n = 45) were female. There was a negative correlation between the CBV index and FIV in a univariable linear regression analysis (Beta =  - 16; 95% CI,  - 23 to  - 8.3; p < 0.001) and a multivariable linear regression model (Beta =  - 9.1 per 0.1 change; 95% CI,  - 15 to  - 2.7; p = 0.006). Diabetes was independently associated with larger FIV (Beta = 46; 95% CI, 16 to 75; p = 0.003). Additionally, a higher baseline ASPECTS was associated with lower FIV (Beta =  - 30; 95% CI,  - 41 to  - 20; p < 0.001).

conclusionOur findings underscore the CBV index as an independent association with FIV in DMVOs, which highlights the critical role of collateral circulation in determining stroke outcomes in this patient population. In addition, our study confirms a negative association of ASPECTS with FLAIR FIV and identifies diabetes as independent factor associated with larger FIV. These insights pave the way for further large-scale, prospective studies to corroborate these findings, thereby refining the strategies for stroke prognostication and management.

Indexed as

Cerebral Blood VolumeAgedComputed Tomography AngiographyFemaleFollow-Up StudiesHumansIschemic StrokeMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesAcute ischemic strokeCerebral blood volumeCollateralsDistal vessel occlusionInfarct volumeMedium vessel occlusion

Identifiers

PMID38507075

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.