MRI-Based Predictors of Hemorrhagic Transformation in Patients With Stroke Treated by Intravenous Thrombolysis

Clinical and biological risk factors for hemorrhagic transformation (HT) after intravenous thrombolysis (IT) have been well established in several registries. The added value of magnetic resonance imaging (MRI) variables has been studied in small samples, and is controversial. We aimed to assess the added value of MRI variables in HT, beyond that of clinical and biological factors. We enrolled 474 consecutive patients with brain infarction treated by IT alone at our primary stroke center between January 2011 and August 2017. Baseline demographic, clinical, biological, and imaging characteristics were collected. MRI variables were: brain infarction volume in cm3; parenchymal fluid attenuated inversion recovery (FLAIR) hyperintensity; FLAIR hyperintense vessel signs; number of microbleeds; subcortical white matter hyperintensity; and thrombus length. Overall, 301patients were included out of 474 (64%). The main causes of exclusion were combined thrombectomy (n=98) and no MRI before IT (n=44). In the bivariate analysis, HT was significantly associated with the presence of more FLAIR hyperintense vessel signs, thrombus length (>8mm), and larger brain infarction volume (diffusion-weighted imaging (DWI) and apparent diffusion coefficient
Source: Frontiers in Neurology - Category: Neurology Source Type: research