Correlation between score and grade of PCV-SWI and hemorrhagic transformation of acute ischemic stroke at high altitude
Li Baona
Yang Xiaoli
Zhang Qingxin
Abstract：Objective To evaluate the collateral circulation in patients with acute ischemic stroke(AIS)by using score and grade of prominent cortical vein(PCV)-susceptibility weighted imaging(SWI),and to analyze the relationship between these two imaging features and hemorrhagic transformation(HT).Methods A total of 68 AIS patients admitted in our hospital between Janu-ary 2018 and December 2022 were enrolled in this study.All of them received multimodal brain MRI scanning to observe and analyze the collateral circulation.Then PCV-SWI assessment was performed to obtain PCV score and grade of the collateral circulation.Within 2 weeks,brain MRI scanning was carried out again to evaluate HT,and then the patients were divided into HT group(n=39)and non-HT group(n=29).The relationship between collateral circulation and HT was analyzed.Results The HT group had significantly larger proportion of PVC grade 3 than the non-HT group(P＜0.01).Among the 68 AIS patients,32 had PCV sign with a PCV-SWI score of 0-7,and 36 were identified non-PCV sign with a score of 8-10.There were 27 patients with PCV sign experiencing HT and only 12 with non-PCV sign having HT,with the PCV patients having a higher incidence of HT than the non-PCV patients(P＜0.01).The PCV patients represented a more extensive PCV,and the incidence of HT accounted for 69.23％in them and 30.77％in the non-PCV patients.Of the 68 AIS patients,61 had a diffusion weighted imaging(DWI)-Alberta Stroke Program Early CT Score(ASPECTS)of ≤7 and 7 had a score of＞7,and the incidence of HT was higher in the patients with a DWI-ASPECTS score of ≤7 than those of a score of＞7(97.44％vs 79.31％,P＜0.05).Binary logistic regression analysis showed that PCV grade and NIHSS score at 10-14 d after admission were independent risk factors for HT(OR=2.128,95％CI:1.200-3.774,P=0.010;OR=1.308,95％CI:1.057-1.620,P=0.014),and DWI-ASPECTS score was a protective factor for HT(OR=0.646,95％CI:0.442-0.945,P=0.024).Conclusion DWI-ASPECTS score,PCV grade,and NIHSS score at 10-14 d after admission are independent predictive risk factors for the occurrence of HT in AIS patients in high-altitude areas.Further clin-ical evaluation of PCV signs and infarct size on images is helpful to predict the early occurrence of HT.
Keywords：strokecollateral circulationcorrelation of datahemorrhagic transformationpromi-nent cortical vein-susceptibility weighted imaging scoreprominent cortical vein grade
Publication Date：2024-08-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 942-947 )