The value of diffusion weighted imaging-alberta stroke program early CT score in predicting stroke-associated pneumonia in patients with acute cerebral infarction: a retrospective study

Zhao, Dong; Zhu, Jing; Cai, Qiang; Zeng, Feifei; Fu, Xiujuan; Hu, Ke

doi:10.7717/peerj.12789

Cited by 8 publications

(5 citation statements)

References 37 publications

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“…The diagnostic accuracy, specificity, and sensitivity of DWI for HICH and HCI were significantly higher than those of routine MRI, with differences of statistical significance ( P < 0.05). This was similar to the findings of Zhao et al [ 29 ], suggesting that DWI could better show the functional and physiological changes of water molecules in human tissues. Therefore, DWI was superior to routine MRI in the detection of both the diseases.…”

Section: Discussionsupporting

confidence: 91%

Diagnostic Value of Image Features of Magnetic Resonance Imaging in Intracranial Hemorrhage and Cerebral Infarction

Tang

Zeng

Zhao

2022

Contrast Media & Molecular Imaging

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This study aimed to investigate the differential diagnosis value of routine magnetic resonance imaging (MRI) and magnetic resonance diffusion-weighted imaging (DWI) in hyperacute intracranial hemorrhage (HICH) and hyperacute cerebral infarction (HCI). Fifty-five patients with HICH were set as group A, and 55 patients with HCI were selected as group B. All the patients underwent routine MRI and DWI examinations. The morphological distribution and signal characteristics (low, high, or mixed) of the lesions in the two groups were recorded. The diagnostic accuracy, sensitivity, and specificity of routine MRI and DWI were compared for distinguishing HICH and HCI. The results suggested that the lesions in patients with HICH were mainly manifested as mixed signals (40 cases), while those in patients with HCI showed high signals (48 cases). HICH occurred in the basal ganglia in 44 cases, in the brain stem in 6 cases, in the cerebellum in 4 cases, in the cerebral cortex in 0 cases, and in the corpus callosum in 1 case. HCI occurred in the basal ganglia area, brain stem, cerebellum, cerebral cortex, and corpus callosum in 5, 3, 35, 12, and 0 cases, respectively. The diagnostic accuracy, specificity, and sensitivity of DWI for HICH and HCI were significantly higher than those of routine MRI P < 0.05 . It was indicated that compared with routine MRI, DWI was more effective in the diagnosis of HICH and HCI, with clearer and more accurate images and better diagnostic performance.

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Section: Discussionsupporting

confidence: 91%

Diagnostic Value of Image Features of Magnetic Resonance Imaging in Intracranial Hemorrhage and Cerebral Infarction

Tang

Zeng

Zhao

2022

Contrast Media & Molecular Imaging

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“…In our study, the AuROC of 24-h ASPECTS for predicting SAP was 0.84 (95% CI, 0.79-0.89). This differs from a previous study that evaluated the use of diffusion-weighted imaging-ASPECTS (DWI-ASPECTS) for SAP prediction (AuROC = 0.74 [95% CI, 0.68-0.80]) (24). Several factors may account for the differences.…”

Section: Discussioncontrasting

confidence: 81%

Serial ASPECTS to predict stroke-associated pneumonia after thrombolysis in patients with acute ischemic stroke

Krongsut,

Soontornpun,

Anusasnee

2024

Front. Neurol.

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BackgroundStroke-associated pneumonia (SAP) is a serious complication in stroke patients, significantly increasing mortality. The Alberta Stroke Program Early CT Score (ASPECTS) is a recognized predictor of acute ischemic stroke outcomes. We aimed to investigate the performance of serial ASPECTS assessments (baseline ASPECTS, 24-h ASPECTS, and change in ASPECTS) for predicting SAP in patients with thrombolyzed acute anterior circulation ischemic stroke (AACIS).MaterialsA retrospective observational cohort study of adult patients with thrombolyzed AACIS was conducted. Baseline and 24-h ASPECTS using non-contrast computed tomography (NCCT), complications of stroke, including SAP and swallowing dysfunction using the Modified Water Swallowing test, were collected. Baseline and 24-h ASPECTS were evaluated by a certified neurologist and neuroradiologist. The predictive performance was determined based on the receiver operating characteristic curve (ROC). Multivariable logistic regression analyses were employed to assess the impact of serial ASPECTS assessment on predicting SAP.ResultsOf the 345 patients with thrombolyzed AACIS in our study, 18.4% (64/345) experienced SAP. The patients’ median age was 62 years [interquartile range (IQR): 52–73], with 53.4% being male. The median NIHSS score was 11 points (IQR: 8–17). The ROC analysis revealed areas under the curve for predicting SAP with baseline ASPECTS, 24-h ASPECTS, and change in ASPECTS were 0.75 (95% CI, 0.69–0.82), 0.84 (95% CI, 0.79–0.89), and 0.82 (95% CI, 0.76–0.87), respectively. Of the three measures, 24-h ASPECTS was a better predictor of SAP (odds ratio: 5.33, 95%CI: 2.08–13.67, p < 0.001) and had a higher sensitivity (0.84 [95%CI, 0.74–0.92]) and specificity (0.79 [95%CI, 0.74–0.84]) than both baseline ASPECTS and change in ASPECTS.Conclusion24-h NCCT-ASPECTS outperformed both baseline ASPECTS and change in ASPECTS for predicting SAP. Notably, 24-h ASPECTS, with a cut-off value of ≤6, exhibited good predictive performance and emerged as the better predictor for SAP.

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“…It has been confirmed by several studies that brain MRI-based imaging features are closely related to SAP. Zhao et al [ 43 ] showed that the DWI Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) used to predict the severity of AIS could also be used to predict the occurrence of SAP in patients with mild AIS [ 1 , 44 ]. We investigated the association between radiomics scores, infarct volumes and NIHSS scores, found that there was a linear positive correlation between radiomics scores and NIHSS scores (Pearson:0.171, P = 0.014), as well as between radiomics scores and infarct volume (Pearson:0.372, P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a clinical-radiomics combined model to predict the occurrence of stroke-associated pneumonia

Luo,

Li,

Chen

et al. 2024

BMC Neurol

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Purpose To explore the predictive value of radiomics in predicting stroke-associated pneumonia (SAP) in acute ischemic stroke (AIS) patients and construct a prediction model based on clinical features and DWI-MRI radiomics features. Methods Univariate and multivariate logistic regression analyses were used to identify the independent clinical predictors for SAP. Pearson correlation analysis and the least absolute shrinkage and selection operator with ten-fold cross-validation were used to calculate the radiomics score for each feature and identify the predictive radiomics features for SAP. Multivariate logistic regression was used to combine the predictive radiomics features with the independent clinical predictors. The prediction performance of the SAP models was evaluated using receiver operating characteristics (ROC), calibration curves, decision curve analysis, and subgroup analyses. Results Triglycerides, the neutrophil-to-lymphocyte ratio, dysphagia, the National Institutes of Health Stroke Scale (NIHSS) score, and internal carotid artery stenosis were identified as clinically independent risk factors for SAP. The radiomics scores in patients with SAP were generally higher than in patients without SAP (P < 0. 05). There was a linear positive correlation between radiomics scores and NIHSS scores, as well as between radiomics scores and infarct volume. Infarct volume showed moderate performance in predicting the occurrence of SAP, with an AUC of 0.635. When compared with the other models, the combined prediction model achieved the best area under the ROC (AUC) in both training (AUC = 0.859, 95% CI 0.759–0.936) and validation (AUC = 0.830, 95% CI 0.758–0.896) cohorts (P < 0.05). The calibration curves and decision curve analysis further confirmed the clinical value of the nomogram. Subgroup analysis showed that this nomogram had potential generalization ability. Conclusion The addition of the radiomics features to the clinical model improved the prediction of SAP in AIS patients, which verified its feasibility.

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The value of diffusion weighted imaging-alberta stroke program early CT score in predicting stroke-associated pneumonia in patients with acute cerebral infarction: a retrospective study

Cited by 8 publications

References 37 publications

Diagnostic Value of Image Features of Magnetic Resonance Imaging in Intracranial Hemorrhage and Cerebral Infarction

Diagnostic Value of Image Features of Magnetic Resonance Imaging in Intracranial Hemorrhage and Cerebral Infarction

Serial ASPECTS to predict stroke-associated pneumonia after thrombolysis in patients with acute ischemic stroke

Feasibility of a clinical-radiomics combined model to predict the occurrence of stroke-associated pneumonia

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