Friday, August 23, 2024

Iron changes within infarct tissue in ischemic stroke patients after successful reperfusion quantified using QSM

 These researchers really need to be retrained in the whole point of stroke research! 100% recovery! They don't even seem to have any clue that is what survivors want

Iron changes within infarct tissue in ischemic stroke patients after successful reperfusion quantified using QSM

written by: Victoria Mercy Kataike, Patricia M. Desmond, Christopher Steward, Peter J. Mitchell, Christian Davey, Nawaf Yassi, Andrew Bivard, Mark W. Parsons, Bruce C.V. Campbell, Felix Ng, Vijay Venkatraman

Appeared in: Neuroradiology



Abstract

Purpose
For nearly half of patients who undergo Endovascular Thrombectomy following ischemic stroke, successful recanalisation does not guarantee a good outcome(Well, because you haven't done one damn thing to stop the 5 causes of the neuronal cascade of death in the first week thus saving millions to billions of neurons. If you don't understand recanalization is only the first step to recovery, you really don't belong in stroke!) . Understanding the underlying tissue changes in the infarct tissue with the help of biomarkers specific to ischemic stroke could offer valuable insights for better treatment and patient management decisions. Using quantitative susceptibility mapping (QSM) MRI to measure cerebral iron concentration, this study aims to track the progression of iron within the infarct lesion after successful reperfusion.
 
Methods
 
In a prospective study of 87 ischemic stroke patients, successfully reperfused patients underwent MRI scans at 24-to-72 h and 3 months after reperfusion. QSM maps were generated from gradient-echo MRI images. QSM values, measured in parts per billion (ppb), were extracted from ROIs defining the infarct and mirror homolog in the contralateral hemisphere and were compared cross-sectionally and longitudinally.
 
Results
 
QSM values in the infarct ROIs matched those of the contralateral ROIs at 24-to-72 h, expressed as median (interquartile range) ppb [0.71(-7.67-10.09) vs. 2.20(-10.50-14.05) ppb, p = 0.55], but were higher at 3 months [10.68(-2.30-21.10) vs. -1.27(-12.98-9.82) ppb, p < 0.001]. The infarct QSM values at 3 months were significantly higher than those at 24-to-72 h [10.41(-2.50-18.27) ppb vs. 1.68(-10.36-12.25) ppb, p < 0.001]. Infarct QSM at 24-to-72 h and patient outcome measured at three months did not demonstrate a significant association.
 
Conclusion 
Following successful endovascular reperfusion(Did it get to 100% recovery? NO? Then it wasn't successful according to the patient! And I don't give a shit about your tyranny of low expectations!), iron concentration in infarct tissue, as measured by QSM increases over time compared to that in healthy tissue. However, its significance warrants further investigation.

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