Background: The goal of the present study was to determine whether the presence or absence of parenchymal FLAIR hyperintensity alone, before thrombolysis, might be a predictive factor of ischemic stroke outcomes after the acute phase of stroke and at 3 months.
Materials and methods: We retrospectively included 84 patients with an ischemic stroke between November 2007 and March 2012, who underwent 3T MRI, were treated by thrombolysis, and had medical follow-up at 3 months. Two readers analyzed parenchymal FLAIR visibility. Logistic regressions were performed for NIHSS difference (NIHSS at admission - NIHSS at the end of hospitalization) and for 3 months modified Ranking Score (mRS). Predictive values of positive parenchymal FLAIR for identifying poor outcome at discharge and at 3 months were estimated.
Results: Parenchymal FLAIR positivity was not predictive of NIHSS difference but it predicted poor outcome at 3 months (sensitivity: 0.49 [0.37-0.60], specificity: 0.69 [0.46-0.91], positive predictive value: 0.87 [0.76-0.98] and negative predictive value: 0.24 [0.12-0.36]).
Conclusions: At 3 Tesla, the presence of a parenchymal hyperintense FLAIR signal before thrombolysis is predictive of a poor clinical outcome at 3 months.
Keywords: Acute stroke; Assessments; Magnetic resonance imaging; Patient outcomes; Prognosis; Therapeutic thrombolysis.
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