Cerebral Perfusion Associates with Short-term Clinical Outcomes of Cerebral Venous Thrombosis
Received Date: September 22, 2020; Published Date: October 15, 2020
Background: To investigate the predictive value of Arterial Spin Labeling (ASL) perfusion imaging for short-term clinical outcomes of cerebral venous thrombosis (CVT) patients.
Materials and methods: Patients diagnosed with CVT by contrast-enhanced magnetic resonance venography (CE-MRV) were recruited and underwent ASL imaging before anticoagulation treatment. The cerebral blood flow (CBF) values in parenchymal abnormalities and the contralateral mirror areas were measured and the ratio of CBF (rCBF) between these two areas was calculated. All patients were followed-up within 3 weeks after treatment and the adverse clinical outcome was recorded. The association between rCBF and adverse clinical outcome was analyzed using logistic regression. The receiver-operating-characteristic (ROC) analysis was utilized to determine the area-under-the-curve (AUC) of rCBF in discriminating adverse clinical outcome.
Results: Twenty-three patients (mean age 42.09±14.71 years; 14 females) were enrolled, of which 7 (30.43%) developed adverse clinical outcomes within 3 weeks. Patients with adverse clinical outcome showed significantly lower rCBF than those without (0.54±0.17 vs. 0.83±0.18, P=0.002). The rCBF was significantly associated with adverse clinical outcome before (odds ration [OR] = 0.207, 95% confidence interval [CI] 0.049- 0.879, P=0.033) and after (OR=0.167, 95% CI 0.030-0.914, P=0.039) adjusting for age and gender. ROC curve analysis indicated that patients with rCBF < 65.2% were more likely to have adverse clinical outcome (AUC=0.893, sensitivity 87.5%, specificity 85.7%).
Conclusion: The cerebral perfusion determined by ASL in CVT patients is associated with short-term adverse clinical outcome, suggesting that baseline cerebral perfusion might be an effective predictor for prognosis in CVT patients.
Keywords: Cerebral venous thrombosis; Cerebral perfusion; Arterial spin labeling; Adverse outcome; Prognosis