Item request has been placed! ×
Item request cannot be made. ×
loading  Processing Request

Use of Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) and Ischemic Core Volume to Determine the Malignant Profile in Acute Stroke.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • المصدر:
      Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: Oxford : Wiley-Blackwell
    • الموضوع:
      Diffusion Magnetic Resonance Imaging* ; Magnetic Resonance Angiography*; Carotid Artery Thrombosis/*diagnostic imaging ; Carotid Artery, Internal/*diagnostic imaging ; Infarction, Middle Cerebral Artery/*diagnostic imaging ; Ischemic Stroke/*diagnostic imaging; Aged ; Aged, 80 and over ; Brain/diagnostic imaging ; Carotid Artery Thrombosis/physiopathology ; Cerebral Angiography ; Endovascular Procedures ; Female ; Humans ; Infarction, Middle Cerebral Artery/physiopathology ; Infarction, Middle Cerebral Artery/therapy ; Ischemic Stroke/physiopathology ; Ischemic Stroke/therapy ; Male ; Middle Aged ; Prognosis ; Registries ; Thrombectomy ; Thrombolytic Therapy
    • نبذة مختصرة :
      Background Malignant profiles were identified by imaging profiles and unfavorable outcomes that have poor response to reperfusion therapy. Many trials have used this profile in their inclusion criteria including large-vessel occlusion acute ischemic stroke trials. We aimed to redefine the cutoff values for malignant profile in acute ischemic stroke patients with large-vessel occlusion regardless of reperfusion therapy. Methods and Results Consecutive acute ischemic stroke patients with anterior large-vessel occlusion were prospectively extracted from the National Cerebral and Cardiovascular Center Stroke Registry between March 2014 and December 2017. Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) and diffusion-weighted imaging lesion ischemic core volume (Vol DWI ) were measured in acute ischemic stroke patients with large-vessel occlusion with or without treatment. Unfavorable outcome was defined as a modified Rankin Scale score 5 to 6 at 3 months, and optimal DWI-ASPECTS and Vol DWI for unfavorable outcome were assessed. In total, 198 patients (111 men, 77±13 years old) were enrolled. Median DWI-ASPECTS was 7 (5-9), and median Vol DWI was 55 (6-134) mL. Among the patients, 72 (36%) patients underwent reperfusion therapy, and 83 (42%) had unfavorable outcomes. The threshold values for a malignant profile on receiver operating characteristic curve analysis for DWI-ASPECTS and Vol DWI were 4 (area under the curve 0.78, P <0.01; sensitivity 0.71, specificity 0.75) and 71 mL (area under the curve 0.80, P <0.01; sensitivity 0.76, specificity 0.77), respectively. Conclusions The cutoff values for our redefined malignant profile were DWI-ASPECTS 4 and Vol DWI 71 mL with no selection bias for reperfusion therapy in the real-world clinical practice. Clinical Trial Registration URL: http://www.clinicaltrials.gov Unique identifier: NCT02251665.
    • References:
      Ann Neurol. 2006 Nov;60(5):508-517. (PMID: 17066483)
      Circ J. 2018 Apr 25;82(5):1443-1450. (PMID: 29607895)
      J Neurol Neurosurg Psychiatry. 2010 Aug;81(8):864-8. (PMID: 20562433)
      Stroke. 2002 May;33(5):1261-6. (PMID: 11988601)
      J Neurol Neurosurg Psychiatry. 2005 Nov;76(11):1528-33. (PMID: 16227545)
      Stroke. 2018 Mar;49(3):e46-e110. (PMID: 29367334)
      Stroke. 1993 Jan;24(1):35-41. (PMID: 7678184)
      N Engl J Med. 2008 Sep 25;359(13):1317-29. (PMID: 18815396)
      N Engl J Med. 2018 Feb 22;378(8):708-718. (PMID: 29364767)
      Lancet Neurol. 2019 Jan;18(1):46-55. (PMID: 30413385)
      Stroke. 2009 Jun;40(6):2046-54. (PMID: 19359641)
      Stroke. 2013 Dec;44(12):3565-7. (PMID: 24092549)
      J Am Heart Assoc. 2019 Nov 19;8(22):e012558. (PMID: 31698986)
      Neurology. 2010 Aug 10;75(6):555-61. (PMID: 20697108)
      N Engl J Med. 2018 Jan 4;378(1):11-21. (PMID: 29129157)
      J Cereb Blood Flow Metab. 2016 Oct;36(10):1780-1789. (PMID: 26661203)
      Stroke. 1988 May;19(5):604-7. (PMID: 3363593)
      J Stroke Cerebrovasc Dis. 2013 Jul;22(5):571-600. (PMID: 23727456)
      Lancet Neurol. 2012 Oct;11(10):860-7. (PMID: 22954705)
      Stroke. 2009 Aug;40(8):2743-8. (PMID: 19498190)
      Lancet. 2016 Apr 23;387(10029):1723-31. (PMID: 26898852)
      Stroke. 2011 Dec;42(12):3435-40. (PMID: 21980202)
      Stroke. 2013 Sep;44(9):2650-63. (PMID: 23920012)
    • Contributed Indexing:
      Keywords: large‐vessel occlusion; malignant profile; stroke
    • Molecular Sequence:
      ClinicalTrials.gov NCT02251665
    • الموضوع:
      Date Created: 20191109 Date Completed: 20201214 Latest Revision: 20240723
    • الموضوع:
      20240723
    • الرقم المعرف:
      PMC6915267
    • الرقم المعرف:
      10.1161/JAHA.119.012558
    • الرقم المعرف:
      31698986