Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Distribution and prognosis of acute ischaemic stroke with negative diffusion-weighted imaging
First author：Yu Wang,Jing Jing
Corresponding author：Yongjun Wang
essential_information
- Person in charge：Yu Wang,Jing Jing
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20190989
- Published time：2022-06-13
2022-06-13
Published articles
Journal：stroke and vascular neurology
Publication type: Original Contributions
IF(IF): 9.893
PMID: 35697388 Link To Pubmed Full text Download
Background And Purpose
Diffusion-weighted imaging (DWI) can help to diagnose acute ischemic stroke (AIS) precisely but DWI-negative can be found in considerable patients. Previous study shows that the prevalence of DWI-negative AIS is 6.8%. However, researches about the prognosis of AIS patient with DWI-negative are rarely seen and no conclusion has been reached. We aimed at exploring risk factors of DWI-negative and association with prognosis in AIS patients.
Method
Patients with AIS with baseline DWI from the Third China National Stroke Registry (CNSR-III), based on a prospective, observational, multicentre cohort study, between August 2015 and March 2018, were included. Patients were classified into negative and positive DWI groups depending on the existence of acute lesions on DWI.
Conclusion
The proportion of patients with DWI-negative AIS gradually decreased as the NIHSS score increased, and negative DWI was mainly observed in patients with mild AIS. Negative DWI was associated with a better prognosis for all patients with AIS. However, these associations were significant for mild AIS but not for those with major AIS.
Main results
Among 12 026 patients who had an ischaemic stroke, 932 (7.7%) had negative DWI. As the NIHSS score increased, the proportion of patients with DWI-negative AIS gradually decreased. Negative DWI was associated with a decreased risk of stroke recurrence (HR 0.63, 95% CI 0.49 to 0.82), combined vascular events (HR 0.72, 95% CI 0.56 to 0.92), mortality (HR 0.60, 95% CI 0.36 to 0.995) and poor functional outcomes (OR 0.57, 95% CI 0.43 to 0.76) within 1 year in all patients. Similar associations were observed in patients with mild AIS (p<0.05 for all) but not in patients with major AIS, excluding poor functional outcomes (OR 0.47, 95% CI 0.28 to 0.81).