Document Detail


Conventional enhancement CT: a valuable tool for evaluating pial collateral flow in acute ischemic stroke.
MedLine Citation:
PMID:  21212666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-01-07
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  31     ISSN:  1421-9786     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2011  
Date Detail:
Created Date:  2011-03-10     Completed Date:  2011-06-24     Revised Date:  2011-08-30    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  346-52     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Affiliation:
Department of Neurology, Ajou University School of Medicine, Suwon, South Korea.
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MeSH Terms
Descriptor/Qualifier:
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:
Cerebrovasc Dis. 2011;32(1):94: author reply 95   [PMID:  21709405 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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