Objective:To investigate the role of collateral circulation in the relationship between the fluid-attenuated inversion recovery(FLAIR)signal intensity ratio(SIR)and time from stroke onset.Methods:A total of 120 patients with acute stroke and clear oneset times from Nanjing First Hospital,Nanjing Medical University were analyzed retrospectively.Magnetic resonance angiography(MRA)was used to evaluate the collateral circulation.Mediation analysis was used to analyze the association between FLAIR SIR and time from stroke onset.Spearman rank correlation and receiver operating characteristic(ROC)curve analysis were performed to evaluate the predictive value of FLAIR SIR in the time from stroke onset.Results:Spearman correlation analysis showed that the FLAIR SIR was significant positive correlation with time from stroke onset in the poor collateral circulation group(r=0.415,P<0.001),while there was no significant correlation between FLAIR SIR and time from stroke onset(r=0.198,P=0.152)in the good collateral circulation group.Mediation analysis indicated that the relationship between FLAIR SIR and time from stroke onset was partially mediated by collateral circulation,accounting for 31.85%of the total effect.ROC analysis demonstrated that the area under the curve(AUC)of FLAIR SIR in predicting the time from stroke onset was 0.870,which was significantly better than the predictive performance of diffusion weighted imaging(DWI)-FLAIR mismatch(AUC=0.645;Z=3.290;P=0.001).Conclusion:The collateral circulation partially mediates the relationship between FLAIR SIR and the time from stroke onset.FLAIR SIR can more accurately predict the time from stroke onset,particularly in patients with poor collateral circulation.
维普
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