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Stroke subtype classification by geometrical descriptors of lesion shape
Bastian Cheng1, Christian Knaack1, Nils Daniel Forkert2
1Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Insights
Small vessel disease stroke lesions have distinct shapes, differentiating them from other stroke types. However, lesion morphology cannot determine if embolic strokes originate from the heart.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Inferring stroke etiology from acute MRI lesion patterns aids patient management and prognosis.
- Classifying stroke subtypes, particularly cardioembolic stroke, is clinically significant.
Purpose of the Study:
- To evaluate the utility of 3D geometrical lesion-shape descriptors for classifying stroke subtypes.
- To specifically assess the ability of these descriptors to identify cardioembolic stroke origins.
Main Methods:
- Retrospective analysis of acute stroke patients classified by ASCOD etiology.
- Segmentation of lesions on diffusion-weighted MRI datasets.
- Quantification of lesion shape descriptors including surface area, sphericity, and volume ratios.
Main Results:
- Small vessel disease lesions were smaller and more spherical than other stroke subtypes.
- No significant morphological differences were found between cardioembolic and non-cardioembolic stroke groups.
- 150 patients were analyzed (mean age 77 years).
Conclusions:
- Distinct morphological properties of stroke lesions can differentiate small vessel disease from other stroke types.
- Lesion morphology, as analyzed, was insufficient to infer the etiology of embolic strokes.
Background And Purpose:
Inference of etiology from lesion pattern in acute magnetic resonance imaging is valuable for management and prognosis of acute stroke patients. This study aims to assess the value of three-dimensional geometrical lesion-shape descriptors for stroke-subtype classification, specifically regarding stroke of cardioembolic origin.
Methods:
Stroke Etiology was classified according to ASCOD in retrospectively selected patients with acute stroke. Lesions were segmented on diffusion-weighed datasets, and descriptors of lesion shape quantified: surface area, sphericity, bounding box volume, and ratio between bounding box and lesion volume. Morphological measures were compared between stroke subtypes classified by ASCOD and between patients with embolic stroke of cardiac and non-cardiac source.
Results:
150 patients (mean age 77 years; 95% CI, 65-80 years; median NIHSS 6, range 0-22) were included. Group comparison of lesion shape measures demonstrated that lesions caused by small-vessel disease were smaller and more spherical compared to other stroke subtypes. No significant differences of morphological measures were detected between patients with cardioembolic and non-cardioembolic stroke.
Conclusion:
Stroke lesions caused by small vessel disease can be distinguished from other stroke lesions based on distinctive morphological properties. However, within the group of embolic strokes, etiology could not be inferred from the morphology measures studied in our analysis.
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