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Prediction of functional outcome using the novel asymmetric middle cerebral artery index in cryptogenic stroke patients

Authors
 Minho Han  ;  Young Dae Kim  ;  Hyung Jong Park  ;  In Gun Hwang  ;  Junghye Choi  ;  Jimin Ha  ;  Ji Hoe Heo  ;  Hyo Suk Nam 
Citation
 PLoS One, Vol.14(1) : e0208918, 2019 
Journal Title
 PLoS One 
Issue Date
2019
Abstract
BACKGROUND: Etiology is unknown in approximately one-quarter of stroke patients after evaluation, which is termed cryptogenic stroke (CS). The prognosis of CS patients is largely undetermined. We created a novel index from transcranial Doppler parameters including mean flow velocity (MV) and pulsatility index (PI) and investigated whether the calculation of asymmetry in the novel parameter can predict functional outcomes in CS patients. METHODS: We made the middle cerebral artery (MCA) index (%) as a novel parameter, which was calculated as 100 X (MCA MV + MCA PI X 10) / (MCA MV-MCA PI X 10). The MCA asymmetry index (%) was also calculated as 100 X (
Rt MCA index-Lt MCA index
) / (Rt MCA index + Lt MCA index) / 2. Poor functional outcomes were defined as modified Rankin Scale score (mRS) ≥3 at 3 months after stroke onset. RESULTS: A total of 377 CS patients were included. Among them, 52 (13.8%) patients had a poor outcome. The overall MCA asymmetry index was two-fold higher in CS patients with a poor outcome (10.26%) compared to those with a good outcome (5.41%, p = 0.002). In multivariable analysis, the overall MCA asymmetry index (OR, 1.054, 95% CI, 1.013-1.096, p = 0.009) and the cutoff value of the overall MCA asymmetry index >9 were associated with poor outcomes at 3 months (OR, 3.737, 95% CI, 1.530-9.128, p = 0.004). CONCLUSION: We demonstrated that the novel asymmetric MCA index can predict short-term functional outcomes in CS patients.
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DOI
10.1371/journal.pone.0208918
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
김영대(Kim, Young Dae) ORCID logo https://orcid.org/0000-0001-5750-2616
남효석(Nam, Hyo Suk) ORCID logo https://orcid.org/0000-0002-4415-3995
박형종(Park, Hyungjong)
허지회(Heo, Ji Hoe) ORCID logo https://orcid.org/0000-0001-9898-3321
황인건(Hwang, In Gun) ORCID logo https://orcid.org/0000-0002-5193-4060
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167325
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