Dissertation/ Thesis
Impact of multimodal MRI in the management of acute ischaemic stroke ; Impact de l'IRM multimodale dans la prise en charge des AVC ischémiques à la phase aigüe
| العنوان: | Impact of multimodal MRI in the management of acute ischaemic stroke ; Impact de l'IRM multimodale dans la prise en charge des AVC ischémiques à la phase aigüe |
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| المؤلفون: | Bani-Sadr, Alexandre |
| المساهمون: | Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Claude Bernard - Lyon I, Yves Berthezène |
| المصدر: | https://theses.hal.science/tel-04594133 ; Santé. Université Claude Bernard - Lyon I, 2023. Français. ⟨NNT : 2023LYO10178⟩. |
| بيانات النشر: | CCSD |
| سنة النشر: | 2023 |
| المجموعة: | Université Jean Monnet – Saint-Etienne: HAL |
| مصطلحات موضوعية: | MRI, Angio-MRI, Perfusion MRI, Cerebral infarction, Mechanical thrombectomy, Ischaemia-reperfusion lesions, Matrix metalloprotease 9, IRM, Angio-IRM, IRM de perfusion, Infarctus cérébral, Thrombectomie mécanique, Lésions d'ischémie-reperfusion, Métalloprotéase matricielle 9, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health |
| الوصف: | Cerebral imaging plays a crucial role in stroke patients. The advent of mechanical thrombectomy has transformed the management of acute ischemic stroke (AIS) patients, and consequently the role of MRI in the acute phase. Here, we propose to study the contribution of multimodal MRI to the management of AIS. To this end, we have coupled the analysis of admission MRI from the HIBISCUS-STROKE (CoHort of Patients to Identify Biological and Imaging markerS of CardiovascUlar Outcomes in Stroke) cohort with functional outcome, final infarct volume and the dynamics of serum markers of inflammation. In the first part of our work, we examined the contribution of MRI to the selection of patients eligible for mechanical thrombectomy. We observed that MRI angiography techniques were inferior to cerebral arteriography in localizing intracranial occlusion, despite taking into account the migratory nature of the thrombus. We showed that the estimation of the volume of the ischemic penumbra varied substantially according to the post-processing software used, and that these differences could have an impact on the selection of patients eligible for mechanical thrombectomy. In a pilot study, we observed that the optimal parameters defining the volumes of perfusion defect varied according to the software used. In the second part of our work, we assessed the prognostic contribution of MRI in patients who had achieved successful recanalization after mechanical thrombectomy. We observed that “brush sign” was associated with >11.6mL growth in infarct volume, and that mild vascular FLAIR hypersignals were associated with poorer functional outcome at 3 months. In the third part of our work, we examined the relationships between blood-brain barrier permeability on admission MRI and neuroinflammatory response. In the total population, we showed that increased blood-brain barrier permeability was associated with greater infarct volume. In patients within 6 hours of the onset of symptoms, we observed that increased permeability was ... |
| نوع الوثيقة: | doctoral or postdoctoral thesis |
| اللغة: | French |
| Relation: | NNT: 2023LYO10178 |
| الاتاحة: | https://theses.hal.science/tel-04594133 https://theses.hal.science/tel-04594133v1/document https://theses.hal.science/tel-04594133v1/file/TH2023BANISADRALEXANDRE.pdf |
| Rights: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.82E15306 |
| قاعدة البيانات: | BASE |
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