Prognosis in Subacute Ischemic Stroke Using Multimodal Imaging

Predicting Prognosis in Subacute Ischemic Stroke Through Brain Perfusion and Collateral Circulation With Multimodal Imaging

We enrolled patients with subacute IS, associated with moderate-to-severe stenosis of the unilateral cervical internal carotid artery, who underwent 4D ASL. Perfusion levels and collateral circulation were compared between groups with favorable prognosis (modified Rankin scale [mRS] ≤ 2) and poor prognosis (mRS > 2).

Inclusion Criteria:

1. Confirmed unilateral internal carotid artery/MCA atherosclerotic stenosis/occlusion with a stenosis degree > 50% verified through computed tomography angiography (CTA), magnetic resonance angiography (MRA), or digital subtraction angiography (DSA).
2. Presence of IS or transient ischemic attack (TIA) symptoms in the circulating blood supply area within the preceding 48 h.
3. Asymptomatic patients with no history of IS or TIA in the past 6 months.
4. Performance of 4D ASL tests during hospitalization.

Exclusion Criteria:

1. Moderate-to-severe stenosis/occlusion of the contralateral internal carotid artery/middle cerebral arteries.
2. Age ≤ 18 years old.
3. Cardioembolic cerebral infarction.
4. Moyamoya disease.
5. Combined or previous cerebral hemorrhage or subarachnoid hemorrhage
6. History of previous cerebral infarction.
7. Claustrophobia or the presence of intracranial metal implants, cochlear implants, or pacemakers.