{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T23:16:12Z","timestamp":1792278972394,"version":"4.4.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T00:00:00Z","timestamp":1673568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82102143"],"award-info":[{"award-number":["82102143"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>The purpose of this study was to evaluate the prognostic value of radiomics-based hyperdense middle cerebral artery sign (HMCAS) for patients with acute ischemic stroke (AIS) after mechanical thrombectomy (MT) and to establish prediction models to identify patients who may benefit more from MT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective study, a total of 102 consecutive patients who presented with HMCAS on non-contrast computed tomography (NCCT) at admission and underwent MT in our hospital between January 2019 and December 2020 were recruited. Among them, 46 experienced favorable outcomes (modified Rankin Scale [mRS] \u2264 2) at 3 months of follow-up. All patients were categorized into two sets, namely, the training set (<jats:italic>n<\/jats:italic> = 81) and the test set (<jats:italic>n<\/jats:italic> = 21). Radiomics features (RFs) and clinical features (CFs) in the training set were selected by statistical analysis to create models. The models' discriminative ability was quantified using the area under the curve (AUC) and confirmed by decision curve analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prediction model established using CFs before MT includes baseline National Institutes of Health Stroke Scale (NIHSS) and neutrophil-to-lymphocyte ratio (NLR) [AUC [95% confidence interval (CI)] = 0.596 (0.312\u20130.881)]. A total of 1,389 RFs were extracted from each hyperdense territory and 8 RFs were left to build the radiomics model [RM; AUC (95%CI) = 0.798 (0.598\u20130.998)]. The model using preoperative CFs and RFs showed good performance [AUC (95%CI) = 0.817 (0.625\u20131.000)]. The models using post-operative CFs alone [AUC (95%CI) = 0.856 (0.685\u20131.000)] or post-operative CFs with RFs [AUC (95%CI) = 0.894 (0.757\u20131.000)] also showed good discrimination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The radiomics-based HMCAS might be a promising tool to predict the prognoses of patients with AIS after MT.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.1037204","type":"journal-article","created":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T04:39:19Z","timestamp":1673584759000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Prognostic value of radiomics-based hyperdense middle cerebral artery sign for patients with acute ischemic stroke after thrombectomy strategy"],"prefix":"10.3389","volume":"13","author":[{"given":"Linna","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongping","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huimao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1161\/01.STR.14.5.756","article-title":"CT visualization of intracranial arterial thromboembolism","volume":"14","author":"Gacs","year":"1983","journal-title":"Stroke."},{"key":"B2","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1161\/STROKEAHA.114.007036","article-title":"Sensitivity and specificity of the hyperdense artery sign for arterial obstruction in acute ischemic stroke","volume":"46","author":"Mair","year":"2015","journal-title":"Stroke."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1161\/STROKEAHA.110.605576","article-title":"CT and MRI early vessel signs reflect clot composition in acute stroke","volume":"42","author":"Liebeskind","year":"2011","journal-title":"Stroke."},{"key":"B4","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1136\/neurintsurg-2016-012391","article-title":"Correlation of imaging and histopathology of thrombi in acute ischemic stroke with etiology and outcome: a systematic review","volume":"9","author":"Brinjikji","year":"2017","journal-title":"J Neurointerv Surg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1177\/1747493021991972","article-title":"Absent hyperdense middle cerebral artery sign is associated with poor functional outcome after mechanical thrombectomy","volume":"17","author":"Ume","year":"2022","journal-title":"Int J Stroke."},{"key":"B6","doi-asserted-by":"publisher","first-page":"39","DOI":"10.3174\/ajnr.A5918","article-title":"Radiomics-based intracranial thrombus features on CT and CTA predict recanalization with intravenous alteplase in patients with acute ischemic stroke","volume":"40","author":"Qiu","year":"2019","journal-title":"AJNR Am J Neuroradiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1117\/12.2581130","article-title":"Clot organization on histology is associated with radiomics features that predict treatment outcomes from mechanical thrombectomy","volume":"11603","author":"Patel","year":"2021","journal-title":"Med Imag 2021 Digital Pathol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1177\/15910199211019176","article-title":"Clot-based radiomics features predict first pass effect in acute ischemic stroke","volume":"28","author":"Sarioglu","year":"2021","journal-title":"Interv Neuroradiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"2488","DOI":"10.1161\/STROKEAHA.120.030334","article-title":"Clot-based radiomics predict a mechanical thrombectomy strategy for successful recanalization in acute ischemic stroke","volume":"51","author":"Hofmeister","year":"2020","journal-title":"Stroke."},{"key":"B10","doi-asserted-by":"publisher","first-page":"19103","DOI":"10.1161\/str.52.suppl_1.P510","article-title":"CT angiographic radiomics signature predicts functional outcome following endovascular thrombectomy in large vessel occlusion stroke","volume":"52","author":"Avery","year":"2021","journal-title":"Stroke"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2981","DOI":"10.1161\/STROKEAHA.115.010049","article-title":"The heidelberg bleeding classification: classification of bleeding events after ischemic stroke and reperfusion therapy","volume":"46","author":"von Kummer","year":"2015","journal-title":"Stroke."},{"key":"B12","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1136\/neurintsurg-2013-010765","article-title":"Hounsfield unit value and clot length in the acutely occluded vessel and time required to achieve thrombectomy, complications and outcome","volume":"6","author":"Spiotta","year":"2014","journal-title":"J Neurointerv Surg."},{"key":"B13","doi-asserted-by":"publisher","first-page":"397","DOI":"10.21037\/qims.2019.12.16","article-title":"Development and assessment of an individualized nomogram to predict colorectal cancer liver metastases","volume":"10","author":"Li","year":"2020","journal-title":"Quant Imaging Med Surg."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e104","DOI":"10.1158\/0008-5472.CAN-17-0339","article-title":"Computational radiomics system to decode the radiographic phenotype","volume":"77","author":"van Griethuysen","year":"2017","journal-title":"Cancer Res."},{"key":"B15","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1038\/nrclinonc.2017.141","article-title":"Radiomics: the bridge between medical imaging and personalized medicine","volume":"14","author":"Lambin","year":"2017","journal-title":"Nat Rev Clin Oncol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"2379","DOI":"10.1161\/STROKEAHA.119.025411","article-title":"Predicting clinical outcomes of large vessel occlusion before mechanical thrombectomy using machine learning","volume":"50","author":"Nishi","year":"2019","journal-title":"Stroke."},{"key":"B17","first-page":"79","article-title":"Prognostic value of the hyperdense middle cerebral artery sign and stroke scale score before ultraearly thrombolytic therapy","volume":"17","author":"Tomsick","year":"1996","journal-title":"AJNR Am J Neuroradiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"313","DOI":"10.2147\/JIR.S293825","article-title":"Association of a high neutrophil-to-lymphocyte ratio with hyperdense artery sign and unfavorable short-term outcomes in patients with acute ischemic stroke","volume":"14","author":"Lin","year":"2021","journal-title":"J Inflamm Res."},{"key":"B19","doi-asserted-by":"publisher","first-page":"2070","DOI":"10.3174\/ajnr.A5825","article-title":"Outcomes of stent retriever vs. aspiration-first thrombectomy in ischemic stroke: a systematic review and meta-analysis","volume":"39","author":"Tsang","year":"2018","journal-title":"AJNR Am J Neuroradiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1016\/S0140-6736(19)30297-1","article-title":"Aspiration thrombectomy vs. stent retriever thrombectomy as first-line approach for large vessel occlusion (compass): a multicentre, randomised, open label, blinded outcome, non-inferiority trial","volume":"393","author":"Turk","year":"2019","journal-title":"Lancet."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.1037204\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T04:39:23Z","timestamp":1673584763000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.1037204\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,13]]},"references-count":20,"alternative-id":["10.3389\/fneur.2022.1037204"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2022.1037204","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,13]]},"article-number":"1037204"}}