La radiologia medica

, Volume 122, Issue 6, pp 412–418 | Cite as

Can neuroimaging differentiate PFO and AF-related cardioembolic stroke from the other embolic sources? Clinical-radiological correlation on a retrospective study

  • Alessandro Stecco
  • Martina Quagliozzi
  • Eleonora Soligo
  • Andrea Naldi
  • Alessia Cassarà
  • Lorenzo Coppo
  • Roberta Rosso
  • Angelo Sante Bongo
  • Paola Amatuzzo
  • Francesco Buemi
  • Elena Guenzi
  • Alessandro Carriero
CARDIAC RADIOLOGY
First Online:
Received:
Accepted:

Abstract

Purpose

The aim of this retrospective study was to map the specific ischemic lesion patterns of distribution in patent foramen ovale-related stroke (PFO-stroke) and atrial fibrillation-related stroke (AF-stroke) in patients with idiopatic ischemic stroke.

Materials and methods

750 ischaemic strokes were screened on basis of diagnostic imaging and tests: patients with known causes were excluded. 171 patients with unknown cause were selected and divided in two groups: AF-stroke (43 patients) and PFO-stroke (128 patients). Vascular territories of ischemic involvement were divided into four classes in each group: the anterior cerebral artery, the middle cerebral artery, the vertebro-cerebral artery (including the posterior cerebral artery) and multisite (MS) involvement.

Results

Infarcts in vertebro-basilar territory and multisite represented each one about 32% of infarcts in PFO-stroke group and their involvement are more frequent than AF-stroke group (p = 0.03). Ischemic lesions in PFO-group were predominantly cortical (34.3%), and in AF-group cortical-subcortical (60.4%). Multisite pattern of ischemic lesion was more frequent in patients with severe degree of right to left shunts (37.5%).

Conclusion

In clinical practice, PFO may be considered a cause of cortical stroke on the basis of radiological findings, when VB vascular territory or MS brain involvement is present in younger patients (<50 age).

Keywords

Stroke Atrial fibrillation Patent foramen ovale Vascular territories Computed tomography Magnetic resonance imaging 
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Notes

Compliance with ethical standards

Conflict of interest

There are no conflicts of interest.

Funding

There are no financial disclosures.

Ethical statement

This type of work does not require approval by Ethics Committee, because of the retrospective nature of the study, but before all diagnostic exams patients received and signed informed consent.

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Copyright information

© Italian Society of Medical Radiology 2017

Authors and Affiliations

  • Alessandro Stecco
    • 1
  • Martina Quagliozzi
    • 2
  • Eleonora Soligo
    • 2
  • Andrea Naldi
    • 3
  • Alessia Cassarà
    • 2
  • Lorenzo Coppo
    • 3
  • Roberta Rosso
    • 4
  • Angelo Sante Bongo
    • 4
  • Paola Amatuzzo
    • 2
  • Francesco Buemi
    • 2
  • Elena Guenzi
    • 2
  • Alessandro Carriero
    • 2
  1. 1.Neuroradiology Unit, Radiology Department, “Maggiore della Carità” HospitalUniversity of Eastern PiedmontNovaraItaly
  2. 2.Radiology Department, “Maggiore della Carità” HospitalUniversity of Eastern PiedmontNovaraItaly
  3. 3.Neurology Department, “Maggiore della Carità” HospitalUniversity of Eastern PiedmontNovaraItaly
  4. 4.Cardiology Department, “Maggiore della Carità” HospitalUniversity of Eastern PiedmontNovaraItaly

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