Acute Symptomatic Basilar Artery Stenosis: MR Imaging Predictors of Early Neurologic Deterioration and Long-term Outcomes
Bibliographic record
Abstract
Purpose To determine clinical, laboratory, and radiologic factors associated with early neurologic deterioration (END) and long-term outcomes in patients with medically treated symptomatic basilar artery stenosis (BAS). Materials and Methods The study design was approved by the institutional review board. From a database of all consecutive patients with cerebrovascular ischemia, the authors retrospectively included 292 patients with medically treated symptomatic BAS with at least 70% stenosis of the basilar artery. The authors evaluated various clinical factors, including National Institutes of Health Stroke Scale (NIHSS) score, C-reactive protein (CRP) level, fibrinogen level, and radiologic factors, including diffusion-weighted (DW) magnetic resonance (MR) imaging-based posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS), hyperintense basilar artery at fluid-attenuated inversion recovery (FLAIR) imaging (FLAIR-hyperintense vessel [FHV]), and clot signs. The outcomes were defined as the development of END and with the 90-day modified Rankin Scale score (favorable score: 0-2). The authors performed a χ(2) test, followed by logistic regression analysis, to identify independent outcome predictors. Results The development of END was highly correlated with unfavorable 90-day modified Rankin Scale score (P < .001). The significant predictors for END were CRP level of at least 1.5 mg/dL (P < .001), NIHSS score of at least 4 (P = .002), pc-ASPECTS of 6 or less (P < .001), and proximal FHV (P = .022). Proximal FHV (P = .010), pc-ASPECTS of 6 or less (P = .002), brainstem involvement (P = .036), and NIHSS score of at least 4 (P < .001) were associated with an unfavorable 90-day modified Rankin Scale score. Neither aggressive medical treatment nor delayed intervention was associated with a favorable 90-day modified Rankin Scale score. Conclusion In medically treated symptomatic BAS, MR imaging parameters such as proximal basilar FHV and DW imaging-based pc-ASPECTS have independent prognostic values for END development and long-term outcomes. (©) RSNA, 2016.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".