Prevalence and Radiographic Characteristics of Cerebral Infarction after Surgery in Patients with Glioma: A Retrospective Study

Abstract

AIM: The aim of our study was to analyze risk factors for postoperative cerebral infarction in patients with glioma in our hospital, and to compare medical imaging techniques for early diagnosis of postoperative cerebral infarction.

METHODS: A retrospective analysis was conducted on 178 patients (male: 78, female: 100) who underwent glioma surgery at our hospital between May 2015 and October 2023. They were divided into two groups based on the presence of postoperative cerebral infarction within 7 days: the cerebral infarction group (n = 85) and the non-cerebral infarction group (n = 93). Magnetic resonance imaging (MRI) was used to assess the location, distribution, and volume of the tumor before surgery. During the perioperative period, patient postoperative time, intraoperative blood loss, and other relevant data were documented. Computed tomography perfusion (CTP) and diffusion-weighted imaging (DWI) imaging techniques were employed to evaluate the occurrence, area, location, and shape of cerebral infarction. The imaging characteristics of postoperative cerebral infarction were noted. Apparent diffusion coefficient values, apparent diffusion coefficient (ADC) of whole-brain CTP parameters, cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT), and DWI parameters were measured. The sensitivity and specificity of CTP, DWI, and their combined diagnosis for postoperative cerebral infarction were compared, with consistency assessed using the Kappa value.

RESULTS: This study found that 85 patients (47.8%) experienced postoperative cerebral infarction. Significant risk factors included tumor location in the temporal lobe, tumor volume ≥23.57 cm³, number of surgeries >1, World Health Organization (WHO) grade >3, and intraoperative blood loss >79.83 mL (p < 0.05). Imaging examinations revealed that CTP combined with DWI diagnosis detected cerebral infarctions in 84 patients, showing lower CBF and CBV, and higher TTP, and MTT in the infarct group (p < 0.05). The Kappa values for CTP, DWI, and the combined diagnosis were 0.762, 0.833, and 0.937, respectively (p < 0.001).

CONCLUSIONS: The prevalence of cerebral infarction in patients with glioma is high and is affected by many factors. Timely imaging examination can detect and predict the occurrence of cerebral infarction in patients after surgery, which is of great significance for improving the prognosis of patients.