title: Parenchymal FLAIR hyperintensity before thrombolysis is a prognostic factor of ischemic stroke outcome at 3 Tesla.
abstract: BACKGROUND
  The goal of the present study was to determine whether the presence or absence of parenchymal FLAIR hyperintensity alone, before thrombolysis, might be a predictive factor of ischemic stroke outcomes after the acute phase of stroke and at 3 months.
  
  
  METHODS
  We retrospectively included 84 patients with an ischemic stroke between November 2007 and March 2012, who underwent 3T MRI, were treated by thrombolysis, and had medical follow-up at 3 months. Two readers analyzed parenchymal FLAIR visibility. Logistic regressions were performed for NIHSS difference (NIHSS at admission - NIHSS at the end of hospitalization) and for 3 months modified Ranking Score (mRS). Predictive values of positive parenchymal FLAIR for identifying poor outcome at discharge and at 3 months were estimated.
  
  
  RESULTS
  Parenchymal FLAIR positivity was not predictive of NIHSS difference but it predicted poor outcome at 3 months (sensitivity: 0.49 [0.37-0.60], specificity: 0.69 [0.46-0.91], positive predictive value: 0.87 [0.76-0.98] and negative predictive value: 0.24 [0.12-0.36]).
  
  
  CONCLUSIONS
  At 3 Tesla, the presence of a parenchymal hyperintense FLAIR signal before thrombolysis is predictive of a poor clinical outcome at 3 months.
authors.affiliation: Department of neuroradiology, hôpital Maison-Blanche, CHU de Reims, Reims university, 45, rue Cognacq-Jay, 51092 Reims cedex, France. Electronic address: semeriau@chu-reims.fr.
authors.forename: Samuel
authors.initials: S
authors.lastname: Emeriau
authors.affiliation: Department of neuroradiology, hôpital Maison-Blanche, CHU de Reims, Reims university, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Soize
authors.affiliation: Department of neuroradiology, hôpital Maison-Blanche, CHU de Reims, Reims university, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Riffaud
authors.affiliation: Department of neuroradiology, hôpital Maison-Blanche, CHU de Reims, Reims university, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Toubas
authors.affiliation: Department of neuroradiology, hôpital Maison-Blanche, CHU de Reims, Reims university, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Pombourcq
authors.affiliation: Department of neuroradiology, hôpital Maison-Blanche, CHU de Reims, Reims university, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Pierot
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020521:Stroke / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D015996:Survival Rate; D015912:Thrombolytic Therapy / Q000401:mortality*
keywords: Acute stroke; Assessments; Magnetic resonance imaging; Patient outcomes; Prognosis; Therapeutic thrombolysis