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PT  - JOURNAL ARTICLE
AU  - Lu, S.S.
AU  - Wu, R.R.
AU  - Cao, Y.Z.
AU  - Xu, X.Q.
AU  - Jia, Z.Y.
AU  - Shi, H.B.
AU  - Liu, S.
AU  - Wu, F.Y.
TI  - Automated Estimation of Quantitative Lesion Water Uptake as a Prognostic Biomarker for Patients with Ischemic Stroke and Large-Vessel Occlusion
AID  - 10.3174/ajnr.A7741
DP  - 2023 Jan 01
TA  - American Journal of Neuroradiology
PG  - 33--39
VI  - 44
IP  - 1
4099  - http://www.ajnr.org/content/44/1/33.short
4100  - http://www.ajnr.org/content/44/1/33.full
SO  - Am. J. Neuroradiol.2023 Jan 01; 44
AB  - BACKGROUND AND PURPOSE: Net water uptake is qualified as an imaging marker of brain edema. We aimed to investigate the ability of net water uptake to predict 90-day functional outcome in patients with acute ischemic stroke and large-vessel occlusion.MATERIALS AND METHODS: A total of 295 consecutive patients were retrospectively enrolled. Automated ASPECTS–net water uptake was calculated on the admission CT. The relationship between ASPECTS–net water uptake and 90-day neurologic outcome was assessed. The independent predictors of favorable outcome (mRS score ≤2) were assessed using multivariate logistic regression analysis and receiver operating characteristic curves and stratified by the ASPECTS.RESULTS: Favorable 90-day outcomes were observed in 156 (52.9%) patients. ASPECTS–net water uptake (OR, 0.79; 95% CI, 0.70–0.90), NIHSS scores (OR, 0.91; 95% CI, 0.87–0.96), age (OR, 0.96; 95% CI, 0.94–0.99), and vessel recanalization (OR, 7.78; 95% CI, 3.96–15.29) were independently associated with favorable outcomes at 90 days (all, P &amp;lt; .01). A lower ASPECTS–net water uptake independently predicted a good prognosis, even in the subgroup of patients with low ASPECTS (≤5) (P &amp;lt; .05). An outcome-prediction model based on these variables yielded an area under the receiver operating characteristic curve of 0.856 (95% CI, 0.814–0.899; sensitivity, 76.3%; specificity, 81.3%).CONCLUSIONS: ASPECTS–net water uptake could independently predict 90-day neurologic outcomes in patients with acute ischemic stroke and large-vessel occlusion. Integrating ASPECTS–net water uptake with clinical models could improve the efficiency of outcome stratification.AISacute ischemic strokeAUCarea under the curveIQRinterquartile rangeLVOlarge-vessel occlusionMTmechanical thrombectomymTICImodified TICINWUnet water uptakeROCreceiver operating characteristic