Small subcortical ischemic infarction and other DWI lesions establish predictive model for MES

Area of Science:

• Neurology
• Radiology
• Cardiology

Background:

• Small subcortical infarctions (SCI) are a type of stroke with poorly understood causes.
• Artery-to-artery embolization is a potential, yet under-researched, cause of SCI.

Purpose of the Study:

• To investigate the association between artery-to-artery embolization and small subcortical infarctions.
• To develop a predictive model for microembolic signals (MES) in acute middle cerebral artery (MCA) stroke.

Main Methods:

• A retrospective observational study included 230 patients with acute MCA stroke.
• Patients were categorized into microembolic signals-positive (MES+) and MES-negative (MES-) groups.
• Diffusion-weighted imaging (DWI) identified infarction patterns, including border zone (BZ), SCI (<10 mm), and cortical ischemia (CI). A nomogram was developed for MES+ prediction.

Main Results:

• Microembolic signals (MES) were detected in 16.5% of patients.
• Border zone (BZ) infarcts, small subcortical infarctions (SCI <10 mm), and cortical ischemia (CI) were independently associated with MES.
• The developed nomogram model demonstrated good predictive performance with an AUC of 0.826.

Conclusions:

• Small subcortical infarctions are associated with microembolic signals (MES).
• A predictive nomogram model incorporating DWI parameters and SCI has been developed for MES+.
• The model shows promising accuracy for clinical application in predicting stroke outcomes.