Classification of lesion area in stroke patients during the subacute phase: a multiparametric MRI study

Multiparametric classification of sub-acute ischemic stroke recovery with ultrafast diffusion, 23 Na, and MPIO-labeled stem cell MRI at 21.1 T

MRI leverages multiple modes of contrast to characterize stroke. High-magnetic-field systems enhance the performance of these MRI measurements. Previously, we have demonstrated that individually sodium and stem cell tracking metrics are enhanced at ultrahigh field in a rat model of stroke, and we have developed robust single-scan diffusion-weighted imaging approaches that utilize spatiotemporal encoding (SPEN) of the apparent diffusion coefficient (ADC) for these challenging field strengths. Here, we performed a multiparametric study of middle cerebral artery occlusion (MCAO) biomarker evolution focusing on comparison of these MRI biomarkers for stroke assessment during sub-acute recovery in rat MCAO models at 21.1 T. T₂ -weighted MRI was used as the benchmark for identification of the ischemic lesion over the course of the study. The number of MPIO-induced voids measured by gradient-recalled echo, the SPEN measurement of ADC, and ²³ Na MRI values were determined in the ischemic area and contralateral hemisphere, and relative performances for stroke classification were compared by receiver operator characteristic analysis. These measurements were associated with unique time-dependent trajectories during stroke recovery that changed the sensitivity and specificity for stroke monitoring during its evolution. Advantages and limitations of these contrasts, and the use of ultrahigh field for multiparametric stroke assessment, are discussed.

Quality of life among patients during subacute phase following stroke during hospitalisation period in Shanghai

Objective: This study aimed to investigate the factors influencing the quality of life of in-hospital subacute stroke patients. Methods: The patients of subacute stroke (within four weeks) in our institution between 2015 and 2016 were recruited. Patients' characteristics and QOL were obtained from medical charts and stroke-specific quality of life scale (SS-QOL). Associations of each domain in SS-QOL with socio-demographic, clinical factors and patient satisfaction were investigated using the linear regression models. Results: Among the 203 subjects, 60 were diagnosed as large artery atherosclerosis (LAA), 80 were small-artery occlusion (SAO), 28 were cardioembolism (CE) and 35 were intracranial haemorrhage (ICH). The ICH group had the worst self-care ability and upper extremity function. Worse severity of stroke was associated with lower levels of language ability, mobility, mood status and upper-extremity function. Participants who had better satisfaction had high levels of capability of conducting family roles, positive emotions, personality consistency, self-care ability and capacity of conducting social roles. Conclusions: The level of patient satisfaction, duration of hospitalisation and the severity of stroke were found to be the three important factors associated with SS-QOL at hospital discharge, indicating doctors might assist patients adjust to the consequences of stroke and improve the QOL of subacute stroke.