ASPECTS discrepancies between CT and MR imaging: analysis and implications for triage protocols in acute ischemic stroke

Journal of Neurointerventional Surgery
Ferdinand HuiShazam Hussain

Abstract

Optimal imaging triage for intervention for large vessel occlusions remains unclear. MR-based imaging provides ischemic core volumes at the cost of increased imaging time. CT Alberta Stroke Program Early CT Score (ASPECTS) estimates are faster, but may be less sensitive. To assesses the rate at which MRI changed management in comparison with CT imaging alone. Retrospective analysis of patients with acute ischemic stroke undergoing imaging triage for endovascular therapy was performed between 2008 and 2013. Univariate and multivariate analyses were performed. Multivariate logistic regression was used to evaluate the effect of time on disagreement in MRI and CT ASPECTS scores. A total of 241 patients underwent both diffusion-weighted imaging (DWI) and CT. Six patients with DWI ASPECTS ≥6 and CT ASPECTS <6 were omitted, leaving 235 patients. For 47 patients, disagreement between the two modalities resulted in different treatment recommendations. The estimated probability of disagreement was 20.0% (95% CI 15.4% to 25.6%). In a multivariate logistic regression, CT ASPECTS >7 (p=0.004) and admission National Institutes of Health Stroke Scale (NIHSS) score <16 (p=0.008) were simultaneously significant predictors of agreement in ASPECT...Continue Reading

References

Jul 26, 2005·Stroke; a Journal of Cerebral Circulation·Juergen BardutzkyMarc Fisher
Dec 13, 2005·Stroke; a Journal of Cerebral Circulation·Jeffrey L Saver
Aug 9, 2006·Neurology·Nicolas U WeirUNKNOWN CASES investigators
Jan 13, 2009·Acta Neurologica Scandinavica·C SøllingL Østergaard
Sep 30, 2009·Neurology·P KhatriUNKNOWN IMS I and II Investigators
Nov 23, 2010·Stroke; a Journal of Cerebral Circulation·Mayank GoyalUNKNOWN Penumbra Pivotal Stroke Trial Investigators, Calgary Stroke Program, and the Seaman MR Research Center
Mar 20, 2012·Stroke; a Journal of Cerebral Circulation·Albert J YooR Gilberto González
Dec 13, 2012·Stroke; a Journal of Cerebral Circulation·Chelsea S KidwellJeffrey L Saver
Feb 12, 2013·The New England Journal of Medicine·Chelsea S KidwellUNKNOWN MR RESCUE Investigators
Apr 30, 2013·Journal of Neurointerventional Surgery·Aquilla S TurkImran Chaudry
Jun 21, 2013·International Journal of Stroke : Official Journal of the International Stroke Society·Bruce C V CampbellGeoffrey A Donnan
Jan 11, 2014·Stroke; a Journal of Cerebral Circulation·Dolora WiscoMuhammad Shazam Hussain
Oct 17, 2014·International Journal of Stroke : Official Journal of the International Stroke Society·Bruce C V CampbellStephen M Davis
Dec 18, 2014·The New England Journal of Medicine·Olvert A BerkhemerUNKNOWN MR CLEAN Investigators
Feb 12, 2015·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA Investigators
Feb 12, 2015·The New England Journal of Medicine·Mayank GoyalUNKNOWN ESCAPE Trial Investigators
Apr 18, 2015·The New England Journal of Medicine·Jeffrey L SaverUNKNOWN SWIFT PRIME Investigators

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Citations

Feb 4, 2019·Journal of Neurointerventional Surgery·Naim KhouryRobert Fahed
Dec 21, 2019·Acta Neurologica Scandinavica·Beatriz FerrazPedro Castro
Apr 18, 2020·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Jose Danilo B DiestroAditya Bharatha
Nov 12, 2018·Journal of Neurointerventional Surgery·Kevin PhanHamed Asadi
Apr 3, 2021·Therapeutic Advances in Neurological Disorders·Peter B SpornsMarios Psychogios
May 16, 2021·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Qianmei JiangGuodong Xiao

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