Diffusion-weighted ASPECTS as an independent marker for predicting functional outcome

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Predicting functional outcome in acute ischemic stroke is crucial for patient management.
• The utility of lesion volume on diffusion-weighted MRI imaging (DWI) for predicting outcomes remains debated.

Purpose of the Study:

• To evaluate the Alberta Stroke Program Early CT Score (ASPECTS) on DWI as a predictor of functional outcome.
• To assess DWI ASPECTS in patients with anterior circulation infarction across a spectrum of stroke severities.

Main Methods:

• Retrospective analysis of 350 patients with first-ever anterior circulation ischemic stroke within 24 hours of onset.
• Comparison of baseline characteristics, clinical data, and MRI findings between favorable (modified Rankin Scale 0-2) and unfavorable (mRS 3-6) outcome groups at 3 months.
• Logistic regression analysis to identify independent predictors of functional outcome.

Main Results:

• Higher DWI ASPECTS scores were associated with favorable functional outcomes.
• National Institutes of Health Stroke Scale (NIHSS) score, prior antithrombotic therapy, DWI ASPECTS, and early neurological deterioration (END) were independent predictors of outcome.
• 62.3% of patients achieved a favorable outcome (mRS 0-2).

Conclusions:

• DWI ASPECTS is a valuable and independent predictor of functional outcome in acute ischemic stroke.
• Integrating DWI ASPECTS with clinical variables enhances the prediction of stroke recovery.
• This scoring system aids in prognostication for anterior circulation stroke patients.