European Radiology: This imaging index has become an emerging predictor of malignant cerebral edema in acute stroke!

Cerebral edema (CED) is an important complication of large vessel occlusion (LVO) in ischemic stroke .
Malignant cerebral edema (MCE) peaks 2 to 5 days after onset and can lead to irreversible tissue damage, insufficient cerebral blood flow, increased intracranial pressure, and even brain herniation .
Therefore, identifying early risk factors for CED may help improve the prognosis of patients with MCE .

Cerebral edema (CED) is an important complication of large vessel occlusion (LVO) in ischemic stroke .

Malignant cerebral edema (MCE) peaks 2 to 5 days after onset and can lead to irreversible tissue damage, insufficient cerebral blood flow, increased intracranial pressure, and even brain herniation .
Therefore, identifying early risk factors for CED may help improve the prognosis of patients with MCE .
stroke vessel

Currently, assessments to monitor the development of edema require close attention to the worsening of clinical neurological symptoms, and high-risk patients may develop new or severe disturbances of consciousness as well as new pupillary abnormalities or diminished responses to pain, but these symptoms are subjective
.

Currently, assessments to monitor the development of edema require close attention to the worsening of clinical neurological symptoms, and high-risk patients may develop new or severe disturbances of consciousness as well as new pupillary abnormalities or diminished responses to pain, but these symptoms are subjective
.

Recently, quantitative lesion net water uptake (NWU) from non-enhanced CT (NECT) emerged as an emerging predictor for assessing ischemic edema and functional outcome
.

However, the application of NWU requires that the infarct area is clearly visible, but most CT images show the infarct area blurred, thus limiting its wide clinical application

Recently, quantitative lesion net water uptake (NWU) from non-enhanced CT (NECT) emerged as an emerging predictor for assessing ischemic edema and functional outcome

The Alberta Stroke Project Early CT Score (ASPECTS) is a semiquantitative scoring system that assesses the extent of infarction, the extent of ischemic changes, and focal swelling in the middle cerebral artery (MCA) region on CT images

Recently, a study published in the journal European Radiology used the auto-ASPECTS technique to measure NWU in patients with areas of acute cerebral ischemia that were automatically detected on baseline multimodal CT (NECT and CTA-SI).
The diagnostic value of baseline ASPECTS-NWU in predicting subsequent MCE was compared with clinical variables

A total of 146 patients with large vessel occlusion were included in this study

CTA-ASPECTS-NWU was moderately positively associated with CED grade (r = 0.

The present study demonstrates that NWU of early affected areas generated by automated-ASPECTS quantification of NECT and CTA-SI at admission allows early identification of patients at risk for developing brain edema after acute LVO

Original source:

JiaQian Shi, Hang Wu, Zheng Dong, et al.

Automated quantitative lesion water uptake in acute stroke is a predictor of malignant cerebral edema .

JiaQian Shi, Hang Wu, Zheng Dong, et al.
Automated quantitative lesion water uptake in acute stroke is a predictor of malignant cerebral edema .
DOI : 10.
1007/s00330-021-08443-2 Automated quantitative lesion water uptake in acute stroke is a predictor of malignant cerebral edema 10.
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