| Early Ischemic Change on CT Versus Diffusion-Weighted Imaging for Patients With Stroke Receiving Intravenous Recombinant Tissue-Type Plasminogen Activator Therapy: Stroke Acute Management with Urgent Risk-factor Assessment and Improvement (SAMURAI) rt-PA Registry. | |
| | |
MedLine Citation:
|
PMID: 21719764 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND AND PURPOSE: 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. METHODS: 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. RESULTS: DWI-ASPECTS was positively correlated with CT-ASPECTS (ρ=0.511, P<0.001) and was lower than CT-ASPECTS (median 8 [interquartile range, 6 to 9] versus 9 [8 to 10], P<0.001). Higher baseline National Institutes of Health Stroke Scale score (standardized partial regression coefficient [β] 0.061, P<0.001) and cardioembolic stroke (β 0.35, P<0.001) were related to this discrepancy. The area under the receiver operating characteristic curve for predicting sICH (12 patients) using ASPECTS was 0.673 (95% CI, 0.503 to 0.807) by CT and 0.764 (95% CI, 0.635 to 0.858) by DWI (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). CONCLUSIONS: 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. |
| | |
Authors:
|
Tomohisa Nezu; Masatoshi Koga; Jyoji Nakagawara; Yoshiaki Shiokawa; Hiroshi Yamagami; Eisuke Furui; Kazumi Kimura; Yasuhiro Hasegawa; Yasushi Okada; Satoshi Okuda; Kazuomi Kario; Masaki Naganuma; Koichiro Maeda; Kazuo Minematsu; Kazunori Toyoda |
Related Documents
:
|
11122904 - New insights on the neuroanatomy of schizophrenia. 6583714 - Clinical correlates of sulcal widening in chronic schizophrenia. 9080354 - Correlation of functional magnetic source imaging with intraoperative cortical stimulat... 6641244 - Ct scan cerebral hemispheric asymmetry measurements in stroke cases with global aphasia... 16918964 - Integrated 18f-fdg pet/ct for the initial evaluation of cervical node level of patients... 17882024 - Computed tomographic histogram analysis in the diagnosis of lipid-poor adenomas: compar... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-6-30 |
Journal Detail:
|
Title: Stroke; a journal of cerebral circulation Volume: - ISSN: 1524-4628 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
|
Created Date: 2011-7-1 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0235266 Medline TA: Stroke Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; the Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan; the Departments of Neurosurgery and Stroke Center, Kyorin University School of Medicine, Mitaka, Japan; the Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan; the Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan; the Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan; the Department of Neurology, St Marianna University School of Medicine, Kawasaki, Japan; the Department of Cerebrovascular Medicine, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan; the Department of Neurology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Sirtuin 1 Retards Hyperphosphatemia-Induced Calcification of Vascular Smooth Muscle Cells.
Next Document: Racial Disparities in Tissue Plasminogen Activator Treatment Rate for Stroke: A Population-Based Stu...