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 (VolDWI) 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 VolDWI. METHODS: DWI-ASPECTS and VolDWI 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 VolDWI were strongly correlated (ρ=-0.82), but each DWI-ASPECTS point corresponded to a wide range of VolDWI. All patients with DWI-ASPECTS≥7 (n=207) had VolDWI<70 mL, whereas 32 of the 34 patients with DWI-ASPECTS<4 had VolDWI>100 mL. However, intermediate DWI-ASPECTS (4-6; n=89) corresponded to highly variable VolDWI (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 VolDWI>100 or <70 mL, respectively.
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 (VolDWI) 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 VolDWI. METHODS: DWI-ASPECTS and VolDWI 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 VolDWI were strongly correlated (ρ=-0.82), but each DWI-ASPECTS point corresponded to a wide range of VolDWI. All patients with DWI-ASPECTS≥7 (n=207) had VolDWI<70 mL, whereas 32 of the 34 patients with DWI-ASPECTS<4 had VolDWI>100 mL. However, intermediate DWI-ASPECTS (4-6; n=89) corresponded to highly variable VolDWI (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 VolDWI>100 or <70 mL, respectively.
Authors: Julian Schröder; Bastian Cheng; Martin Ebinger; Martin Köhrmann; Ona Wu; Dong-Wha Kang; David S Liebeskind; Thomas Tourdias; Oliver C Singer; Soren Christensen; Bruce Campbell; Marie Luby; Steven Warach; Jens Fiehler; Jochen B Fiebach; Christian Gerloff; Götz Thomalla Journal: Stroke Date: 2014-10-14 Impact factor: 7.914
Authors: F Danière; K Lobotesis; P Machi; O Eker; I Mourand; C Riquelme; X Ayrignac; J F Vendrell; G Gascou; J Fendeleur; C Dargazanli; R Schaub; H Brunel; C Arquizan; A Bonafé; V Costalat Journal: AJNR Am J Neuroradiol Date: 2014-10-01 Impact factor: 3.825
Authors: Dezhi Liu; Yongkun Li; Zhaorong Shi; Stephen M Davis; Ka Sing Wong; Thomas W Leung; Bernard Yan; Yunyun Xiong; Wen Sun; Gelin Xu; Renliang Zhang; Xinfeng Liu Journal: Neuroradiology Date: 2014-09-09 Impact factor: 2.804