Value of MRI T2 FLAIR Vascular Hyperintensities Combined with DWI ASPECTS in Predicting the Prognosis of Acute Cerebral Infarction with Endovascular Treatment.

Objective: To explore the MRI T2 fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH) combined with diffusion-weighted imaging (DWI) Alberta Stroke Program Early CT Score (ASPECTS) in predicting the prognosis of acute cerebral infarction (ACI) with endovascular treatment.

Methods: The patients with ACI in the anterior circulation who underwent endovascular treatment from June 2016 to December 2020 were divided into a good prognosis group and a poor prognosis group according to the modified Rankin Scale (mRS) score at 90 days after the operation. The differences in general clinical baseline data, CT-ASPECTS, FVH, and DWI-ASPECTS between the two groups were analyzed. The receiver operating characteristic (ROC) curve was used to analyze the predictive power of prediction models on prognosis.

Results: The results of the Binomial Logistic regression equation showed initial National Institute of Health stroke scale (NIHSS), Mori grade, DWI-ASPECTS, and FVH were independent risk factors for prognosis. The predictive power of the FVH + DWI-ASPECTS prediction model was highest, and the predictive power of DWI-ASPECTS was higher than that of CT-ASPECTS.

Conclusion: DWI-ASPECTS is better than CT-ASPECTS in predicting the prognosis of ACI with endovascular treatment, and the combined prediction model of FVH and DWI-ASPECTS has higher prediction performance, which can be used as a preoperative evaluation method to predict the effect of endovascular treatment for ACI.