Abstract

Aim: This study aimed to evaluate the prognostic value of absolute interhemispheric ADC differences (ΔADC) in patients with AIS due to large vessel occlusion (LVO) who underwent endovascular therapy (EVT).
Materials and Methods: In this retrospective observational study, 100 patients with acute LVO stroke who underwent endovascular treatment and pre-treatment diffusion-weighted MRI were included. A total of 100 patients (mean age:66.6 years, 95% CI:64.0–69.2; 46% male) with acute ischemic stroke due to large vessel occlusion were retrospectively analyzed. ADC values were measured from infarcted regions and their contralateral homologous areas to calculate ΔADC. Functional outcome at discharge was assessed using the modified Rankin Scale (mRS), and receiver operating characteristic (ROC) analysis was performed to evaluate the predictive performance of ΔADC for poor outcomes (mRS≥5).
Results: The mean ΔADC was 295.7±150.4×10⁻⁶ mm²/s. Patients with better functional outcomes (mRS 0–4) exhibited consistently higher mean ADC differences (e.g., mRS 4:374.2×10⁻⁶ mm²/s), whereas those with poor outcomes had notably lower values (mRS 5:211.0; mRS 6:42.0×10⁻⁶ mm²/s). A significant negative correlation was found between ΔADC and mRS score (r=–0.29, p=0.003). ROC analysis yielded an AUC of 0.75 (p

Key words: Acute ischemic stroke, large vessel occlusion, endovascular thrombectomy, diffusion-weighted magnetic resonance imaging, apparent diffusion coefficient, interhemispheric asymmetry, stroke outcome prediction