Erschienen in:
09.06.2022 | Neuro
Prognostic value of ASPECTS on post-treatment diffusion-weighted imaging for acute ischemic stroke patients after endovascular thrombectomy: comparison with infarction volume
verfasst von:
Xiao-Quan Xu, Yue Chu, Guang-Chen Shen, Gao Ma, Shan-Shan Lu, Sheng Liu, Hai-Bin Shi, Fei-Yun Wu
Erschienen in:
European Radiology
|
Ausgabe 12/2022
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Abstract
Objectives
To assess the prognostic value of Alberta Stroke Program Early Computed Tomography Score (ASPECTS) on post-treatment diffusion-weighted imaging (DWI) for acute ischemic stroke (AIS) patients after endovascular thrombectomy (EVT) and compare it with that of infarction volume.
Methods
Ninety-eight consecutive AIS patients who underwent EVT and post-treatment DWI were retrospectively enrolled. ASPECTS and infarction volume were evaluated based on post-treatment DWI, respectively. Good clinical outcome was defined as modified Rankin Scale score of 0–2 at 90 days. Predictors of good clinical outcome were evaluated using univariate and multivariate logistic regression analysis. Prognostic value of post-treatment DWI ASPECTS and infarction volume were assessed and compared using receiver-operating-characteristic curves and the DeLong method.
Results
Favorable outcome was achieved in 62 (63.3%) patients. A strong correlation was found between post-treatment DWI ASPECTS and infarction volume (ρ = −0.847). Due to strong correlation and potential collinearity, two multivariate logistic regression models were respectively developed which included post-treatment DWI ASPECTS or infarction volume. As a result, post-treatment DWI ASPECTS (OR, 2.401; 95%CI, 1.567–3.678; p < 0.001) and infarction volume (OR, 0.982; 95%CI, 0.846–0.998; p = 0.002) were both independent predictors of good clinical outcome. Setting post-treatment DWI ASPECTS ≥ 6 as a cut-off value, optimal performance (AUC = 0.836; sensitivity, 87.1%; specificity, 66.7%) could be obtained in predicting good clinical outcome, which was comparable with that of infarction volume (cut-off volume, ≤ 94.87 ml; AUC = 0.821; sensitivity, 90.3%; specificity, 55.6%).
Conclusions
Post-treatment DWI ASPECTS might be a potential surrogate of infarction volume and be effective in predicting the clinical outcome of AIS patients after EVT.
Key Points
• Post-treatment DWI ASPECTS correlated significantly with infarction volume.
• A post-treatment DWI ASPECTS ≥ 6 best predicts good outcomes for AIS patients after EVT.
• Post-treatment DWI ASPECTS has the potential in substituting infarction volume in predicting the clinical outcome of AIS patients.