MRI patient selection for endovascular thrombectomy in acute ischemic stroke: correlation between pretreatment diffusion weighted imaging and outcome scores

Federica Vernuccio, Francesca Granata, Antonio Pitrone, Rosario Papa, Enricomaria Mormina, Gianmarco Bernava, Alessandro Calamuneri, Marcello Longo, Giuseppe Centorrino, Agostino Tessitore, Antonio A. Caragliano, Gianmarco Bernava, Rosa Musolino, Sergio L. Vinci, Rosa Musolino, Federico Midiri

Risultato della ricerca: Article

Abstract

Introduction: Eligibility for endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) depends, amongst other factors, on CT- or MR-based scores. The aim of this study was to investigate the role of Alberta Stroke Program Early CT score based on diffusion weighted imaging (MR-ASPECT) in the assessment of brain damage pre-EVT, patient selection for EVT and outcome. Materials and methods: We included in this study patients with National Institute of Health stroke score (NIHSS) at admission ≥ 8, MR-ASPECT ≥ 5 and anterior AIS, who were treated with EVT in our hospital. All patients were clinically evaluated at admission, post-EVT, discharge and at 3-month follow-up. We used MR-ASPECT to establish infarct core extension at admission. We evaluated ASPECT score at admission (CT-ASPECT-IN), 24 h after EVT and at discharge, NIHSS, modified Ranking Scale (mRS), Thrombolysis in Cerebral Infarction scale (TICI), onset-to-intervention-delay (OTID) and Collateral Circulation Score (CCS). Results: 68 patients (mean age 78 ± 11.9 years) were included in this study. 54.4 and 64.7% of patients had strong clinical improvement after 24 h from EVT and at discharge, respectively. NIHSS evaluated 24 h after EVT correlated with CCS, TICI and OTID. We observed a favourable outcome (mRS 0–2) in 52.9% of patients at 3-month follow-up. MR-ASPECT score correlated with post-EVT outcome better than CT-ASPECT-IN scores. Conclusion: MR-ASPECT score based on diffusion weighted imaging is useful for the selection of patients with AIS that can have a favourable outcome from EVT. A prompt EVT has huge impact on patient outcome.
Lingua originaleEnglish
pagine (da-a)1-9
Numero di pagine9
RivistaLA RADIOLOGIA MEDICA
Stato di pubblicazionePublished - 2018

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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    Vernuccio, F., Granata, F., Pitrone, A., Papa, R., Mormina, E., Bernava, G., Calamuneri, A., Longo, M., Centorrino, G., Tessitore, A., Caragliano, A. A., Bernava, G., Musolino, R., Vinci, S. L., Musolino, R., & Midiri, F. (2018). MRI patient selection for endovascular thrombectomy in acute ischemic stroke: correlation between pretreatment diffusion weighted imaging and outcome scores. LA RADIOLOGIA MEDICA, 1-9.