The probability of middle cerebral artery MRA flow signal abnormality with quantified CT ischaemic change: targets for future therapeutic studies

Journal of Neurology, Neurosurgery, and Psychiatry
P A BarberA M Buchan

Abstract

In this study we define the probability of vascular abnormality in the middle cerebral artery (MCA) territory according to the extent of ischaemic change seen using computed tomography (CT). We assessed the sensitivity and specificity of the hyperdense middle cerebral artery (HMCA) and the "dot" sign using magnetic resonance angiography (MRA). Patients presenting with ischaemic stroke had a CT scan (<6 h) prior to MRI (<7 h). A quantitative CT scoring system (ASPECTS) was applied to CT and diffusion weighted images (DWI) at baseline and follow up (24 h) by five independent observers. The presence of HMCA and the MCA "dot" sign was also evaluated. An expert reader assessed the 3D time of flight (TOF) MRA in the anterior circulation for areas of decreased vascular signal in the MCA territory, with an absent signal taken to represent severely reduced or absent flow. A total of 100 consecutive patients had baseline CT and MR scans. The median NIHSS was 9. The median CT ASPECTS was 8 and equalled the median DWI ASPECTS. There were a total of 10 HMCA and 19 MCA "dot" signs, with four patients having both HMCA and "dot" signs. A total of 47 MRA flow signal abnormalities were observed in the anterior circulation. In the absence of acce...Continue Reading

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Citations

Oct 18, 2005·Journal of Neurology, Neurosurgery, and Psychiatry·P A BarberUNKNOWN ASPECTS Study Group
Sep 19, 2007·Critical Care : the Official Journal of the Critical Care Forum·Ramez Reda Moustafa, Jean-Claude Baron
Jul 9, 2011·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Teruyuki HiranoUNKNOWN Japan Alteplase Clinical Trial Group
Sep 22, 2009·International Journal of Stroke : Official Journal of the International Stroke Society·V PuetzA M Demchuk
Oct 4, 2005·Neuroimaging Clinics of North America·Thomas Kucinski
Oct 4, 2005·Neuroimaging Clinics of North America·Andrew M Demchuk, Shelagh B Coutts
Sep 17, 2005·Stroke; a Journal of Cerebral Circulation·Andrew M DemchukUNKNOWN NINDS rtPA Stroke Study Group, NIH
Dec 6, 2014·Stroke; a Journal of Cerebral Circulation·Grant MairUNKNOWN IST-3 Collaborative Group
Sep 6, 2005·Clinical Chemistry·Laure AllardJean-Charles Sanchez
Jul 15, 2015·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Anne-Marie GuerguerianSuzanne Laughlin
Aug 18, 2006·Lancet Neurology·Keith W MuirJean-Claude Baron

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