Thrombus length predicts outcome of middle cerebral artery occlusion: a high-resolution MRI study

BackgroundHigh-resolution magnetic resonance imaging (MRI) is a feasible method for identifying and measuring luminal thrombosis in the occluded middle cerebral artery (MCA) of stroke patients.PurposeTo evaluate the relationship between thrombus length in the middle cerebral artery (MCA) and clinical prognosis in stroke patients using high-resolution MRI (T1-weighted [T1W]-CUBE).Material and MethodsIn this retrospective study, patients with MCA thrombi were identified via high-resolution MRI. Thrombus length was measured using T1W-CUBE sequences, and clinical prognosis was assessed using modified Rankin scale (mRS) scores at a 3-month follow-up. Patients were categorized into good or poor prognosis groups based on mRS scores. Statistical analyses compared thrombus length and diameter between groups. Restricted cubic spline (RCS) analyses were performed to examine the relationship between thrombus length, diameter, and mRS scores. Multiple logistic regression was used to explore the association between thrombus length and prognosis.ResultsThe mean thrombus length was significantly longer in the poor prognosis group compared to the good prognosis group (25.69 ± 8.78 mm vs. 15.11 ± 6.91 mm; <i>P</i> <0.001). Thrombus diameter did not significantly differ between the groups (<i>P</i> = 0.961). RCS showed a monotonically increasing relationship between thrombus length and log OR of mRS. Multiple logistic regression indicated that each additional millimeter of thrombus length increased the risk of poor prognosis by 1.22 times (odds ratio = 1.22, 95% confidence interval = 1.11-1.40; <i>P</i> <0.05).ConclusionMCA thrombus length is a significant predictor of prognosis in stroke patients, with longer thrombi associated with worse clinical outcomes.