Abstract:Objective To evaluate the relationship between cortical ribbon sign in magnetic resonance diffusion weighted imaging (DWI) and prognosis of mechanical thrombectomy to explore the reliability of DWI cortical ribbon sign for screening in patients with acute ischemic stroke (AIS) suitable for thrombectomy. Methods A retrospective analysis was performed on the preoperative DWI characteristics of 50 AIS patients undergoing thrombectomy with successful recanalization ［modified thrombolysis in cerebral infarction (mTICI)2b/3］ in the First Affiliated Hospital of Xi'an Jiaotong University (15 cases), Xidian Group Hospital (12 cases), Xianyang First People's Hospital (8 cases), Xi'an Daxing Hospital (10 cases) and Xi'an Central Hospital (5 cases) from January 2018 to October 2021. DWI cortical ribbon sign was defined as the banded shape of high signals with limited diffusion on cortical surface or gyrus surface, and the relationship between cortical ribbon sign and clinical prognosis was analyzed. Results There were 30 patients with DWI cortical ribbon sign (DWI cortical ribbon sign group) and 20 patients without cortical ribbon sign (cortical ribbon-free group) . There was no significant difference in age, gender, admission NIHSS score, ASPECT score, pathogenesis, time from onset to admission, time from stroke onset to puncture and time from puncture to successful recanalization between two groups (P＞0.05). The proportion of 90-day modified Rankin scale (mRS) score ≤2 in cortical ribbon sign group was significantly higher than that in cortical ribbon free group (60.0% vs25.0%, P＜0.05), while the incidence of postoperative malignant cerebral edema was significantly lower in cortical ribbon sign group than that in coritical ribbon free group (10.0% vs 45.0%, P＜0.05). Conclusion DWI cortical ribbon sign is related to the good prognosis of thrombectomy and can be used as a simple mode for image screening of AIS patients who are suitable or not for thrombectomy.