patient participation
This was a post hoc analysis of a PET cerebral atherosclerosis study comparing two radioligands. 18F-fluorodeoxyglucose (FDG) and NaF for detection of causative atheroma in 20 patients with acute ischemic strokeFourThe study and its protocol were reviewed and approved by the Institutional Review Board of Chuan University Hospital (C2015061), and written informed consent was obtained from each patient included in the study in accordance with the Declaration of Helsinki.Inclusion and exclusion criteria and demographic characteristics have been reported elsewhereFiveBriefly, patients with acute ischemic stroke admitted to Chuan University Hospital with >50% carotid artery stenosis as measured by CT angiography were eligible, but those with active cancer or autoimmune disease, putative thread, were eligible. Patients with advanced renal impairment with a spherical filtration rate <30 mg/mmol, uncontrolled diabetes mellitus, or other unstable medical conditions were excluded. All included patients underwent a comprehensive stroke etiology assessment, including brain MRI, and neurological status was assessed using the National Institutes of Health Stroke Scale (NIHSS) on admission and the Modified Rankin Scale (mRS) after discharge. Rated.Brain MR imaging was performed as previously described using a 3.0-T MR unit (Avanto, Philips, Eindhoven, The Netherlands) including axial and sagittal T1-weighted spin echoes. rice field [repetition time (TR) = 450 ms, echo time (TE) = 10 ms, and 5-mm-thick slices with a 1-mm gap]axial T2-weighted fast spin echo (TR = 3000 ms and TE = 80 ms), axial fluid-attenuated reversal recovery (TR = 9000 ms and TE = 120 ms), susceptibility-weighted imaging (SWI; TR = 22.1 ms), TE = 31.1 ms, and 10-mm-thick slices spaced 5 mm apart) and diffusion-weighted images (DWI; b = 0 and 1000 s/mm, TR = 3000 ms, and TE = 74.8 ms). to all patients6.
Positron emission tomography and brain imaging
Whole-body PET/CT was performed on a combined scanner (Gemini TF 16, Philips Medical Systems, Cleveland, Ohio) 60 minutes after an 8-hour fast and an intravenous NaF injection of 259–370 MBq (7–10 mCi). ) was performed using PET images were acquired for his 5 min/bed on the head and 1 min/bed from the base of the skull to the proximal thigh immediately after the CT scan (120 kVp, 50 mA). Maximum and mean standardized uptake values (SUV) of the infarct area were measured on the scan in which the infarct area was greatest by drawing a region of interest that could cover most of the infarct area. Mean SUVs of the pons and cerebellum were also obtained from each patient.Mean SUV of the liver, spleen, and lumbar spine were determined as previously describedFive.
statistical analysis
Clinical and laboratory information were presented as categorical variables and median number of patients (percentage). [25th—75th percentiles] for continuous variables. First, he compared NaF uptake levels according to different brain MRI sequences, including DWI. Because DWI is known to represent early neuronal injury after ischemic stroke by detecting changes in the diffusion of water molecules associated with cytotoxic edema.7, the patients were first dichotomized into two groups, the DWI (+) group included patients with DWI-positive lesions and the DWI (−) group included patients without DWI lesions.Mann-Whitney was used to compare NaF uptake levels in the infarct area between the two groups cormorant test. Mean cerebellar NaF uptake was calculated for each patient and compared to non-infarcted brain regions, including the pons and cerebellum, as controls. We also compared the mean SUV of His NaF in the spleen, liver, and lumbar spine between the two groups. To test whether NaF uptake in the brain might be affected by hemorrhagic transformation or vasogenic edema due to cerebral infarction, we performed a study between infarct regions with and without susceptibility-weighted imaging abnormalities, and We compared mean NaF uptake between infarct areas with and without FLAIR abnormalities.
Second, to understand the clinical significance or pathophysiological mechanisms of NaF uptake in brain tissue, Spearman’s correlation analysis between NaF uptake levels and clinical variables including early neurological severity and laboratory data. was done. Patients were dichotomized into two groups according to neurological severity and functional independence as mRS 0–2 vs. mRS 3–6 at 3 months after stroke.8 Period between index stroke and NaF PET investigation. All statistical analyzes were performed using SPSS (version 22.0; SPSS Inc., Chicago, IL) and P < 0.05 was considered statistically significant.
