Early Ischemic Change on CT Versus Diffusion-Weighted Imaging for Patients With Stroke Receiving Intravenous Recombinant Tissue-Type Plasminogen Activator Therapy
- 1 August 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 42 (8), 2196-2200
- https://doi.org/10.1161/strokeaha.111.614404
Abstract
Alberta Stroke Programme Early CT Score (ASPECTS) is a quantitative topographical score to evaluate early ischemic change in the middle cerebral arterial territory on CT as well as on diffusion-weighted imaging (DWI). The aim of the present study was to elucidate the relationship between CT-ASPECTS and DWI-ASPECTS for patients with hyperacute stroke and their associations with outcomes after recombinant tissue-type plasminogen activator therapy based on a multicenter registry. ASPECTS was assessed on both CT and DWI before intravenous 0.6 mg/kg alteplase in 360 patients with stroke (119 women, 71±11 years old). The outcomes were symptomatic intracerebral hemorrhage within 36 hours and independence at 3 months defined by a modified Rankin Scale score of 0 to 2. DWI-ASPECTS was positively correlated with CT-ASPECTS (ρ=0.511, P P P P P =0.275). The area for predicting independence at 3 months (192 patients) was 0.621 (0.564 to 0.674) by CT and 0.639 (0.580 to 0.694) by DWI ( P =0.535). For patients with hyperacute stroke, DWI-ASPECTS scored approximately 1 point lower than CT-ASPECTS. Both CT-ASPECTS and DWI-ASPECTS were useful predictors of symptomatic intracerebral hemorrhage and independence at 3 months after recombinant tissue-type plasminogen activator.Keywords
This publication has 22 references indexed in Scilit:
- Atlas-Based Topographical Scoring for Magnetic Resonance Imaging of Acute StrokeStroke, 2010
- Routine Use of Intravenous Low-Dose Recombinant Tissue Plasminogen Activator in Japanese PatientsStroke, 2009
- Risk Assessment of Symptomatic Intracerebral Hemorrhage After Thrombolysis Using DWI-ASPECTSStroke, 2009
- Large Ischemic Lesions on Diffusion-Weighted Imaging Done Before Intravenous Tissue Plasminogen Activator Thrombolysis Predicts a Poor Outcome in Patients With Acute StrokeStroke, 2008
- Outline of the Japanese Guidelines for the Management of Stroke 2004 and Subsequent RevisionInternational Journal of Stroke, 2008
- MRI-Based and CT-Based Thrombolytic Therapy in Acute Stroke Within and Beyond Established Time WindowsStroke, 2007
- Guidelines for the Early Management of Adults With Ischemic StrokeStroke, 2007
- Alteplase at 0.6 mg/kg for Acute Ischemic Stroke Within 3 Hours of OnsetStroke, 2006
- MRI Screening Before Standard Tissue Plasminogen Activator Therapy Is Feasible and SafeStroke, 2005
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke, 1993