Related Experiment Video
Updated: Jan 27, 2026
Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli
Published on: September 25, 2016
Outcomes of Symptomatic Anterior Large Vessel Occlusion by Initial Imaging Assessment Using Diffusion-Weighted
Naruhiko Kamogawa1, Kanta Tanaka2, Hiroshi Yamagami3
1Department of Cerebrovascular Medicine National Hospital Organization Osaka National Hospital Osaka Japan.
Background:
We aimed to compare outcomes after stroke due to anterior circulation large vessel occlusion with initial imaging assessments using diffusion-weighted imaging (DWI) or noncontrast computed tomography (NCCT).
Methods:
Among 2399 patients with large vessel occlusion stroke in a prospective, multicenter registry, patients with (1) prestroke modified Rankin Scale scores 0 to 1, (2) occlusion of the internal carotid artery or M1 segment of the middle cerebral artery, and (3) onset-to-hospital-arrival time <6 hours were included. The primary effectiveness outcome was good functional outcome, defined as modified Rankin Scale scores 0 to 2 at 3 months. Safety outcomes included symptomatic intracranial hemorrhage. Intergroup biases were accounted for by mixed-effects multivariable modeling and inverse probability of treatment weighting.
Results:
A total of 343 patients (130 women [37.9%]; median age, 74 years [interquartile range, IQR, 66-82 years]) were analyzed. DWI-based assessment was performed in 217 patients, and NCCT-based assessment was performed in 126 patients. The DWI group showed a lower baseline National Institutes of Health Stroke Scale score (P<0.01) and lower Alberta Stroke Program Early CT Score (P<0.01) than the NCCT group. Frequency of endovascular therapy was lower in the DWI group (71.9%) than in the NCCT group (84.1%; P<0.01). Median hospital-arrival-to-arterial-puncture time was 55 minutes (IQR, 40-77.5 minutes) in the DWI group and 55 minutes (IQR, 35-80 minutes) in the NCCT group (P=0.89), with similar rates of successful recanalization (77.6% versus 76.4%, respectively; P=0.88). Frequency of good functional outcome was 47.0% in the DWI group and 41.3% in the NCCT group (adjusted odds ratio, 1.32; 95% CI, 0.49-3.55). Symptomatic intracranial hemorrhage was encountered in 2.8% in the DWI group and 1.6% in the NCCT group (P=0.71).
Conclusions:
Potential difference in accuracy of ischemic damage assessment between the 2 modalities did not seem to affect outcomes of anterior circulation large vessel occlusion stroke.
Registration:
URL: https://www.clinicaltrials.gov; Unique identifier: NCT02419794.
More Related Videos
06:57Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection
Published on: September 22, 2023
13:16Computed Tomography and Optical Imaging of Osteogenesis-angiogenesis Coupling to Assess Integration of Cranial Bone Autografts and Allografts
Published on: December 22, 2015
Related Concept Videos
01:27Imaging Studies III: Computed Tomography
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:17Assessment of Diffusion and Perfusion
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this...
01:25Imaging Studies II: Positron Emission Tomography and Scintigraphy
Fundamental Principles of PET
01:12Diffusion
01:21Diffusion