| Conventional enhancement CT: a valuable tool for evaluating pial collateral flow in acute ischemic stroke. | |
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MedLine Citation:
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PMID: 21212666 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To establish an easy and rapid method for evaluating pial collateral flow, we compared the Alberta Stroke Program Early CT Score (ASPECTS) on nonenhanced CT (NECT), conventional contrast-enhanced CT (CECT), and CT angiography source images (CTA-SI) in patients with acute ischemic stroke. METHODS: We reviewed 55 consecutive patients with acute ischemic stroke involving the anterior circulation who underwent thrombolysis within 6 h of referral to the stroke center. We evaluated axial images using NECT, CECT and CTA-SI. Pial collateral formation was graded as fair (1-2 points) or bad (3-5 points) based on 4-vessel angiography. The outcomes were dichotomized into good (modified Rankin Scale, mRS 0-2) or poor (mRS 3-6) using a 90-day mRS. RESULTS: Demographics (age, sex, initial National Institutes of Health Stroke Scale score, time to CT acquisition and stroke subtypes) did not significantly differ between patients with fair or bad collateral formation. ASPECTS on CECT (r = -0.788, p < 0.0001) was more inversely correlated with pial collateral formation than ASPECTS on NECT (r = -0.557, p < 0.0001) or ASPECTS on CTA-SI (r = -0.662, p < 0.0001). Furthermore, ASPECTS on CECT demonstrated a high discriminative capability, with an area under the receiver operating characteristic curve of 0.885 for fair collateral circulation, compared to 0.790 for ASPECTS on NECT and 0.794 for ASPECTS on CTA-SI. Multiple regression analysis revealed that ASPECTS on CECT (≥8) was an independent predictor for fair collateral circulation (odds ratio = 23.00, p < 0.001) and a good prognosis (odds ratio = 17.81, p < 0.001). CONCLUSION: ASPECTS on CECT is a feasible method for predicting pial collateral flow and overall outcomes in acute ischemic stroke. |
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Authors:
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Jun Young Choi; Eun Jin Kim; Ji Man Hong; Sung Eun Lee; Jin Soo Lee; Yong Cheol Lim; Ho Sung Kim |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2011-01-07 |
Journal Detail:
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Title: Cerebrovascular diseases (Basel, Switzerland) Volume: 31 ISSN: 1421-9786 ISO Abbreviation: Cerebrovasc. Dis. Publication Date: 2011 |
Date Detail:
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Created Date: 2011-03-10 Completed Date: 2011-06-24 Revised Date: 2011-08-30 |
Medline Journal Info:
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Nlm Unique ID: 9100851 Medline TA: Cerebrovasc Dis Country: Switzerland |
Other Details:
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Languages: eng Pagination: 346-52 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 S. Karger AG, Basel. |
Affiliation:
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Department of Neurology, Ajou University School of Medicine, Suwon, South Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Angiography, Digital Subtraction Brain Ischemia / drug therapy, physiopathology, radiography* Cerebral Angiography / methods* Cerebral Arteries / physiopathology, radiography* Cerebrovascular Circulation* Chi-Square Distribution Collateral Circulation* Female Humans Logistic Models Male Middle Aged Odds Ratio Pia Mater / blood supply* Predictive Value of Tests ROC Curve Radiographic Image Interpretation, Computer-Assisted Republic of Korea Retrospective Studies Risk Assessment Risk Factors Stroke / drug therapy, physiopathology, radiography* Thrombolytic Therapy Time Factors Tomography, X-Ray Computed* Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Cerebrovasc Dis. 2011;32(1):94: author reply 95
[PMID:
21709405
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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