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Related Concept Videos

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Related Experiment Video

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Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
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Collateral flow and brain changes on computed tomography angiography predict infarct volume on early

Junya Aoki1, Yohei Tateishi1, Christopher L Cummings1

  • 1Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|December 3, 2014
PubMed
Summary

A computed tomography (CT) score can predict large infarcts on early diffusion-weighted magnetic resonance imaging (DWI). Alberta Stroke Program Early Computed Tomography Score (ASPECTS) and collateral flow on CT angiography source images (CTA-SI) help exclude large infarcts.

Keywords:
Acute strokecomputed tomographycomputed tomography angiographymagnetic resonance imaging

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Acute ischemic stroke management relies on early reperfusion therapies.
  • Predicting infarct core size is crucial for treatment decisions in stroke patients.

Purpose of the Study:

  • To determine if a computed tomography (CT)-based score can predict large infarcts (≥ 80 mL) on early diffusion-weighted magnetic resonance imaging (DWI).

Main Methods:

  • Retrospective analysis of 56 acute stroke patients eligible for endovascular therapy within 8 hours of symptom onset.
  • Alberta Stroke Program Early Computed Tomography Score (ASPECTS) assessed on noncontrast CT and CT angiography source images (CTA-SI).
  • Limited collateral flow defined as <50% filling on CTA-SI.

Main Results:

  • Large infarct group (n=27) had lower ASPECTS on noncontrast CT (5 vs. 9) and CTA-SI (3 vs. 8) compared to the small infarct group (n=29) (P < .001).
  • Limited collateral flow was significantly more frequent in the large infarct group (92% vs. 11%, P < .001).
  • CTA-SI ASPECTS ≤ 5 (OR, 40.55) and limited collateral flow (OR, 114.64) were independently associated with large infarcts.

Conclusions:

  • CT-based assessment of ASPECTS and collateral status on CTA-SI can effectively exclude patients with large infarcts on early DWI.
  • This imaging approach may aid in optimizing treatment selection for acute stroke.