An Intermodal Correlation Study among Imaging, Histology, Procedural and Clinical Parameters in Cerebral Thrombi Retrieved from Anterior Circulation Ischemic Stroke Patients

Abstract

The precise characterization of cerebral thrombi prior to an interventional procedure can ease the procedure and increase its success. This study investigates how well cerebral thrombi can be characterized by computed tomography (CT), magnetic resonance (MR) and histology, and how parameters obtained by these methods correlate with each other as well as with the interventional procedure and clinical parameters. Cerebral thrombi of 25 patients diagnosed by CT with acute ischemic stroke were acquired by mechanical thrombectomy and, subsequently, scanned by a high spatial-resolution 3D MRI including T1-weighted imaging, apparent diffusion coefficient (ADC), T2 mapping and then finally analyzed by histology. Parameter pairs with Pearson correlation coefficient more than 0.5 were further considered by explaining a possible cause for the correlation and its impact on the difficulty of the interventional procedure and the treatment outcome. Significant correlations were found between the variability of ADC and the duration of the mechanical recanalization, the deviation in average Hounsfield units (HU) and the number of passes with the thrombectomy device, length of the thrombus, its RBC content and many others. This study also demonstrates the clinical potentials of high spatial resolution multiparametric MRI in characterization of thrombi and its use for interventional procedure planning.

New Advances in Diagnostic Radiology for Ischemic Stroke

“…As a further current important research topic, the detailed analysis of thrombi retrieved from endovascular procedures may be of great importance in order to increase the success of interventional treatment. Viltuznik et al [15] investigated the accuracy of cerebral thrombus characterization via computed tomography (CT), magnetic resonance (MR), and histology, and how several parameters attained using these methods are correlated with each other. Finally, these parameters' association with interventional procedures and clinical variables was investigated.…”

Analysis of the expression level and predictive value of CLEC16A|miR-654-5p|RARA regulatory axis in the peripheral blood of patients with ischemic stroke based on biosignature analysis

“…The current diagnosis of stroke relies on clinical symptoms and medical imaging techniques. The most commonly used diagnostic tools for IS are computed tomography (CT) and magnetic resonance (MR) (3). However, CT has poor sensitivity to early ischemic changes in the brain and most patients do not show typical imaging changes in the early stages of the disease, which may miss the optimal time for treatment.…”