Can DWI-ASPECTS Substitute for Lesion Volume in Acute Stroke?

被引：98

作者：

de Margerie-Mellon, Constance ^{[1
]}

Turc, Guillaume ^{[2
]}

Tisserand, Marie ^{[1
]}

Naggara, Olivier ^{[1
]}

Calvet, David ^{[2
]}

Legrand, Laurence ^{[1
]}

Meder, Jean-Francois ^{[1
]}

Mas, Jean-Louis ^{[2
]}

Baron, Jean-Claude ^{[2
]}

Oppenheim, Catherine ^{[1
]}

机构：

[1] Univ Paris 05, Ctr Psychiat & Neurosci, Sorbonne Paris Cite, Dept Radiol,Ctr Hosp St Anne,INSERM S894, F-75014 Paris, France

[2] Univ Paris 05, Ctr Psychiat & Neurosci, Sorbonne Paris Cite, Dept Neurol,Ctr Hosp St Anne,INSERM S894, F-75014 Paris, France

来源：

STROKE | 2013年 / 44卷 / 12期

关键词：

ASPECTS; diffusion-weighted imaging; stroke; thrombolytic therapy; PLASMINOGEN ACTIVATOR THROMBOLYSIS; ISCHEMIC-STROKE; DIFFUSION; PREDICTS; MRI; IMPROVEMENT; SELECTION;

D O I：

10.1161/STROKEAHA.113.003047

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose The extent of diffusion lesion on pretreatment imaging is a risk factor for poor outcome and hemorrhagic transformation after thrombolysis, and volumes of 70 to 100 mL have been advocated as cut-offs. However, estimating diffusion-weighted imaging (DWI) lesion volume (Vol(DWI)) in the acute setting may be cumbersome. We aimed to determine whether the DWI-Alberta Stroke Program Early CT Score (DWI-ASPECTS) can substitute for Vol(DWI). Methods DWI-ASPECTS and Vol(DWI) were measured retrospectively on pretreatment MRI (median onset-to-MRI delay=122 minutes) in 330 consecutively treated patients with middle cerebral artery stroke. Results DWI-ASPECTS and Vol(DWI) were strongly correlated (=-0.82), but each DWI-ASPECTS point corresponded to a wide range of Vol(DWI). All patients with DWI-ASPECTS 7 (n=207) had Vol(DWI) <70 mL, whereas 32 of the 34 patients with DWI-ASPECTS <4 had Vol(DWI) >100 mL. However, intermediate DWI-ASPECTS (4-6; n=89) corresponded to highly variable Vol(DWI) (median, 66 mL; interquartile range, 40-98). Conclusions Although each DWI-ASPECTS point corresponds to a wide range of volumes, DWI-ASPECTS <4 or 7 may be used as reliable surrogates of Vol(DWI) >100 or <70 mL, respectively.

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页码：3565 / 3567

页数：3

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