[Neuroimaging characteristics of cryptogenic stroke with and without patent foramen ovale].

Objective: To explore the neuroimaging characteristics associated with the presence of patent foramen ovale(PFO) for patients with cryptogenic stroke. Methods: We retrospectively collected the clinical and imaging data of cryptogenic stroke patients with PFO and without PFO from Henan Province People's Hospital from January 1, 2013 to June 30, 2017. Lesion patterns and pertinent vascular territory were compared between the two groups. Multivariate logistic regression analysis was used to explore the independent predictors for the presence of PFO. Results: A total of 54 cryptogenic stroke patients with PFO and 50 cases without PFO were recruited. Compared with PFO(-) stroke group, more patients in PFO(+ ) stroke group had migraine(P=0.036), and patients in PFO(+ ) stroke group had higher Risk of Paradoxical Embolism(RoPE) score(P=0.030). The lesion pattern of PFO(+ ) stroke was more frequently observed as multiple lesions in multicirculatory (P=0.035), and infarcts were more likely to be distributed in the vertebrobasilar artery territory (P=0.041); the most frequently involved vessel was the posterior cerebral artery region (P=0.006). More patients with PFO(+ ) stroke had old silent stroke lesion(P=0.021). On multivariate analysis, infarction distributed in the posterior cerebral artery region(OR=4.292, 95% CI 1.469-12.543, P=0.008), silent stroke lesion (OR=6.688, 95% CI 1.277-35.029, P=0.024), and high RoPE score (OR=1.393, 95% CI 1.026-1.893, P=0.034) were independent parameters that could predict the presence of PFO. Conclusions: Multiple lesions in multicirculatory and the posterior predominance are neuroimaging characteristics of cryptogenic stroke with PFO. Infarction distributed in the posterior cerebral artery region, silent stroke lesion and high RoPE score are independent predictors of the presence of PFO.

[Diagnostic value of clot burden score of susceptibility vessel sign in arterial thrombosis of acute ischemic stroke and its association with prognosis].

Objective: To analysis the value of susceptibility vessel sign (SVS) in susceptibility weighted imaging (SWI) in detecting thrombogenesis in middle cerebral artery (MCA) and its association with clinical prognosis. Methods: From December 2014 to December 2015 in People's Hospital of Zhengzhou University, we retrospectively examined clinical, imaging and experimental datafrom 104 consecutive patients with acute ischemic strokeand compared the consistency of detecting thrombus between SWI and magnetic resonance angiography (MRA) using Kappa analysis. Clot Burden Score (CBS) was used to analysis extent and scope of thrombus. The association between CBS and clinical prognosiswere analyzed by Spearman rank correlation. Results: Mean age was 60 years old of the 104 patients with acute cerebral infarction and female accounted for 32%. There were 39 patients (37.5%) with SVS positive in SWI and 32 patients (30.8%) with both SVS positive and MRA occlusion or severe stenosis. The consistency in predicting arterial thrombosis of occlusion or severe stenosis between MRA and SVS in SWI was statistically significant (Kappa=0.502, P<0.001). There were 6 cases with SVS positive and none stenosis in MRA, and all the clots in this 6 case were located in distal artery. CBS was significantly associated with 3-month outcome (Spearman ρ =-0.472; P<0.001). Conclusion: SWI is superior to MRA for the detection of intracranial distal thrombus in patients with acute ischemic stroke of the MCA territory. Higher clot burden(lower CBS) could be an important clinical tool to estimate poor outcome in patients with acutecerebral infarction.