Imaging predictors of progressive infarction in patients with anterior circulation small subcortical infarction

The purpose of the present study is to investigate the association between imaging characteristics and progressive infarction (PI) in patients with anterior circulation single subcortical infarction (ACSSI).

Between January 2020 and October 2022, we retrospectively enrolled 638 ACSSI patients admitted to the Stroke Unit of First Affiliated Hospital of Nanchang University within 48 h after symptom onset. Demographic characteristics, clinical information, laboratory data, and imaging features (the number of infarct slices and the maximal diameter of infarcts) were collected.

There were 121 patients with PI, accounting for 18.9% of the total. In univariate analysis, the infarct slice number tended to be higher in the PI group (P < 0.05). Additionally, patients with PI had a higher frequency of infarct diameter≥ 10 mm and infarct slices≥3 than patients without PI (P < 0.05). Patients diagnosed with branch atheromatous disease (BAD) were more likely to develop PI compared to lacunar infarction (LI) when BAD was defined as axial slices of infarcts ≥ 3 and the infarct diameter ≥10 mm (P < 0.05). Multivariate logistic analysis revealed that slice number ≥ 3 remained slightly significant after adjusting all variables with P < 0.05. Finally, receiver operating characteristic curves were used to compare discriminative abilities and suggested slices of infarcts ≥ 3 were superior to other imaging variables to predict PI in ACSSI patients.

The present study suggests a lesion visible ≥3 slices is independently correlated with PI in ACSSI patients. The slice number of infarcts in ASCCI is a superior indicator to predict PI than other imaging markers.