Association of FLAIR Positivity and Worse Outcomes After Intravenous Thrombolysis in Known-Onset Strokes A Systematic Review and Meta-Analysis /

Background/Objectives: MRI FLAIR signal serves as a time surrogate in unknown onset strokes; however, its prognostic value in early known-onset strokes treated with intravenous thrombolysis (IVT) remains unclear. We aim to evaluate whether FLAIR positivity predicts hemorrhagic transformation and les...

Teljes leírás

Elmentve itt :
Bibliográfiai részletek
Szerzők: Zhubi Esra
Bissenov Azamat
Lengyel Anna Sára
Réka Tóth
Horváth András Attila
Kéri Szabolcs
Engh Marie Anne
Hegyi Péter
Gunda Bence
Dokumentumtípus: Cikk
Megjelent: 2025
Sorozat:JOURNAL OF CLINICAL MEDICINE 14 No. 22
Tárgyszavak:
doi:10.3390/jcm14228031

mtmt:36434001
Online Access:http://publicatio.bibl.u-szeged.hu/39552
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245 1 0 |a Association of FLAIR Positivity and Worse Outcomes After Intravenous Thrombolysis in Known-Onset Strokes  |h [elektronikus dokumentum] :  |b A Systematic Review and Meta-Analysis /  |c  Zhubi Esra 
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490 0 |a JOURNAL OF CLINICAL MEDICINE  |v 14 No. 22 
520 3 |a Background/Objectives: MRI FLAIR signal serves as a time surrogate in unknown onset strokes; however, its prognostic value in early known-onset strokes treated with intravenous thrombolysis (IVT) remains unclear. We aim to evaluate whether FLAIR positivity predicts hemorrhagic transformation and less favorable functional outcome following IVT within 4.5 h of symptom onset. Methods: A systematic search of Embase, PubMed, and Cochrane Library was conducted. We included studies reporting 90-day functional outcome and hemorrhagic transformation after intravenous thrombolysis within 4.5 h of symptom onset in relation to the FLAIR signal on pre-treatment MRI. Two reviewers independently extracted data and assessed bias using QUIPS. A random-effects model was used for meta-analysis. The study protocol was registered in PROSPERO (CRD42023486781). Results: Six studies comprising 951 patients were included in the final analysis. Patients with FLAIR-positive lesions (25.86%) had non-significantly higher odds of hemorrhagic transformation (OR, 3.47; 95% CI, 0.51-23.57; p = 0.131) and significantly higher odds of unfavorable 90-day outcome (OR, 2.14; 95% CI, 1.01-4.55; p = 0.049). The pooled sensitivity and specificity of FLAIR status for predicting hemorrhagic transformation were 41.2% and 82.1%. The pooled sensitivity and specificity of FLAIR status for predicting less favorable outcome were 40.9% and 78.1%, respectively. Conclusions: FLAIR positivity is significantly associated with less favorable 90-day functional outcome and a trend toward a higher rate of hemorrhagic transformation following IVT within 4.5 h of symptom onset. It may aid risk stratification but should not preclude treatment in eligible patients. 
650 4 |a Klinikai orvostan 
700 0 1 |a Bissenov Azamat  |e aut 
700 0 1 |a Lengyel Anna Sára  |e aut 
700 0 1 |a Réka Tóth  |e aut 
700 0 1 |a Horváth András Attila  |e aut 
700 0 1 |a Kéri Szabolcs  |e aut 
700 0 1 |a Engh Marie Anne  |e aut 
700 0 1 |a Hegyi Péter  |e aut 
700 0 1 |a Gunda Bence  |e aut 
856 4 0 |u http://publicatio.bibl.u-szeged.hu/39552/1/36434001_jcm-14-08031.pdf  |z Dokumentum-elérés