Location-Specific Net Water Uptake and Malignant Cerebral Edema in Acute Anterior Circulation Occlusion Ischemic Stroke
Bibliographic record
Abstract
ABSTRACT BACKGROUND AND PURPOSE: Early identification of malignant cerebral edema (MCE) in patients with acute ischemic stroke is crucial for timely interventions. We aimed to identify regions critically associated with MCE using the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) to evaluate the association between location-specific-net water uptake (NWU) and MCE. MATERIALS AND METHODS: This multicentre, retrospective cohort study included patients with acute ischemic stroke following large anterior circulation occlusion. The ASPECTS was determined by RAPID ASPECTS software. ASPECTS-NWU and Region-NWU were calculated automatically by comparing the Hounsfield units values in the ischemic and contralateral regions. Critical ASPECTS MCE regions and Region-NWU were evaluated by multivariate logistic regression and the areas under the receiver operating characteristic curves (AUCs). RESULTS: The study included 513 patients. Multivariate analysis showed that the ASPECTS insula (OR=2.49; 95% CI, 1.44–4.31) and M5 (OR=1.59; 95% CI, 1.11–3.41) regions were significantly associated with MCE. After adjustment, only the insula (OR=2.34; 95% CI, 1.23–4.45) was independently associated with MCE. Univariable ROC analysis found AUCs for Insula-NWU (AUC, 0.70; 95% CI, 0.65– 0.76)and ASPECTS-NWU (AUC, 0.64; 95% CI, 0.58-0.70) .The Insula-NWU had better diagnostic power than ASPECTS-NWU (DeLong test; P=0.01). A multivariate regression model that combined the NIHSS, ASPECTS, insula involvement, and Insula-NWU had good discriminatory power (AUC=0.80; 95% CI, 0.74–0.86) and better diagnostic power than Insula-NWU (DeLong test; P<0.01). CONCLUSIONS: Brief statement directed to the stated purpose or hypothesis; no references should be cited.The insula region is critical for MCE, and Insula-NWU has better prediction efficacy than ASPECTS-NWU. This method does not rely on advanced imaging, facilitating rapid assessment in emergencies. ABBREVIATIONS: ASPECTS = the Alberta Stroke Program Early Computed Tomography Score; AUC= the areas under the receiver operating characteristic curve; CT=computed tomography; CTP=CT perfusion; HU = hounsfield unit; MCE = malignant cerebral edema; NCCT=non-contrast Computed Tomography; NWU = net water uptake; ROC = receiver operating characteristic curve.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 | 0.001 |
| 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".