Validity of acute stroke lesion volume estimation by diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomographic Score depends on lesion location in 496 patients with middle cerebral artery stroke.
Stroke. 2014-10-14; 45(12): 3583-3588
DOI: 10.1161/strokeaha.114.006694
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1. Stroke. 2014 Dec;45(12):3583-8. doi: 10.1161/STROKEAHA.114.006694. Epub 2014 Oct
14.
Validity of acute stroke lesion volume estimation by diffusion-weighted
imaging-Alberta Stroke Program Early Computed Tomographic Score depends on lesion
location in 496 patients with middle cerebral artery stroke.
Schröder J(1), Cheng B(2), Ebinger M(2), Köhrmann M(2), Wu O(2), Kang DW(2),
Liebeskind DS(2), Tourdias T(2), Singer OC(2), Christensen S(2), Campbell B(2),
Luby M(2), Warach S(2), Fiehler J(2), Fiebach JB(2), Gerloff C(2), Thomalla G(2);
STIR and VISTA Imaging Investigators.
Collaborators: Warach S, Albers G, Davis S, Donnan G, Fisher M, Furlan A, Grotta
J, Hacke W, Kang DW, Kidwell C, Koroshetz W, Lees KR, Lev M, Liebeskind DS,
Sorensen A, Thijs V, Thomalla G, Wardlaw J, Wintermark M, Cheng B, Ebinger M, Hao
Q, Tourdias T, Wu O, Kim JS, Breuer L, Singer OC, Luby M, Warach S, Christensen
S, Treszl A, Forkert ND, Galinovic I, Rosenkranz M, Engelhorn T, Köhrmann M,
Endres M, Kang DW, Dousset V, Sorensen A, Liebeskind DS, Fiebach JB, Fiehler J,
Gerloff C.
Author information:
(1)From the Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum,
Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany (J.S., B. Cheng, C.G.,
G.T.); Centrum für Schlaganfallforschung Berlin, Charité-Universitätsmedizin
Berlin, Berlin, Germany (M.E., J.B.F.); Klinik für Neurologie, Universität
Erlangen-Nürnberg, Erlangen, Germany (M.K.); Department of Radiology, Athinoula A
Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard
Medical School, Boston (O.W.); Department of Neurology, Asan Medical Center,
University of Ulsan College of Medicine, Seoul, South Korea (D.-W.K.); Department
of Neurology, University of California, Los Angeles (D.S.L.); Université de
Bordeaux, CHU de Bordeaux, Service de NeuroImagerie Diagnostique de
Thérapeutique, Bordeaux, France (T.T.); Klinik für Neurologie,
Universitätsklinikum Frankfurt, Frankfurt, Germany (O.C.S.); Department of
Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital,
University of Melbourne, Parkville, Australia (S.C., B. Campbell); National
Institute of Neurological Disorders and Stroke, Bethesda, MD (M.L.); Department
of Neurology and Neurotherapeutics, Seton/UT Southwestern Clinical Research
Institute of Austin, UT Southwestern Medical Center, Austin, TX (S.W.); and
Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention,
Unversitätsklinikum Hamburg-Eppendorf, Hamburg, Germany (J.F.).
.
(2)From the Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum,
Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany (J.S., B. Cheng, C.G.,
G.T.); Centrum für Schlaganfallforschung Berlin, Charité-Universitätsmedizin
Berlin, Berlin, Germany (M.E., J.B.F.); Klinik für Neurologie, Universität
Erlangen-Nürnberg, Erlangen, Germany (M.K.); Department of Radiology, Athinoula A
Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard
Medical School, Boston (O.W.); Department of Neurology, Asan Medical Center,
University of Ulsan College of Medicine, Seoul, South Korea (D.-W.K.); Department
of Neurology, University of California, Los Angeles (D.S.L.); Université de
Bordeaux, CHU de Bordeaux, Service de NeuroImagerie Diagnostique de
Thérapeutique, Bordeaux, France (T.T.); Klinik für Neurologie,
Universitätsklinikum Frankfurt, Frankfurt, Germany (O.C.S.); Department of
Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital,
University of Melbourne, Parkville, Australia (S.C., B. Campbell); National
Institute of Neurological Disorders and Stroke, Bethesda, MD (M.L.); Department
of Neurology and Neurotherapeutics, Seton/UT Southwestern Clinical Research
Institute of Austin, UT Southwestern Medical Center, Austin, TX (S.W.); and
Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention,
Unversitätsklinikum Hamburg-Eppendorf, Hamburg, Germany (J.F.).
BACKGROUND AND PURPOSE: Alberta Stroke Program Early Computed Tomographic Score
(ASPECTS) has been used to estimate diffusion-weighted imaging (DWI) lesion
volume in acute stroke. We aimed to assess correlations of DWI-ASPECTS with
lesion volume in different middle cerebral artery (MCA) subregions and reproduce
existing ASPECTS thresholds of a malignant profile defined by lesion volume ≥100
mL.
METHODS: We analyzed data of patients with MCA stroke from a prospective
observational study of DWI and fluid-attenuated inversion recovery in acute
stroke. DWI-ASPECTS and lesion volume were calculated. The population was divided
into subgroups based on lesion localization (superficial MCA territory, deep MCA
territory, or both). Correlation of ASPECTS and infarct volume was calculated,
and receiver-operating characteristics curve analysis was performed to identify
the optimal ASPECTS threshold for ≥100-mL lesion volume.
RESULTS: A total of 496 patients were included. There was a significant negative
correlation between ASPECTS and DWI lesion volume (r=-0.78; P