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

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

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

Cita questo

MRI patient selection for endovascular thrombectomy in acute ischemic stroke: correlation between pretreatment diffusion weighted imaging and outcome scores. / Vernuccio, Federica; Midiri, Federico; Vinci, Sergio L.; Musolino, Rosa; Granata, Francesca; Pitrone, Antonio; Mormina, Enricomaria; Bernava, Gianmarco; Calamuneri, Alessandro; Longo, Marcello; Papa, Rosario; Centorrino, Giuseppe; Tessitore, Agostino; Caragliano, Antonio A.

In: LA RADIOLOGIA MEDICA, 2018, pag. 1-9.

Risultato della ricerca: Article

Vernuccio, F, Midiri, F, Vinci, SL, Musolino, R, Granata, F, Pitrone, A, Mormina, E, Bernava, G, Calamuneri, A, Longo, M, Papa, R, Centorrino, G, Tessitore, A & Caragliano, AA 2018, 'MRI patient selection for endovascular thrombectomy in acute ischemic stroke: correlation between pretreatment diffusion weighted imaging and outcome scores', LA RADIOLOGIA MEDICA, pagg. 1-9.
Vernuccio, Federica ; Midiri, Federico ; Vinci, Sergio L. ; Musolino, Rosa ; Granata, Francesca ; Pitrone, Antonio ; Mormina, Enricomaria ; Bernava, Gianmarco ; Calamuneri, Alessandro ; Longo, Marcello ; Papa, Rosario ; Centorrino, Giuseppe ; Tessitore, Agostino ; Caragliano, Antonio A. / MRI patient selection for endovascular thrombectomy in acute ischemic stroke: correlation between pretreatment diffusion weighted imaging and outcome scores. In: LA RADIOLOGIA MEDICA. 2018 ; pagg. 1-9.
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title = "MRI patient selection for endovascular thrombectomy in acute ischemic stroke: correlation between pretreatment diffusion weighted imaging and outcome scores",
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.",
author = "Federica Vernuccio and Federico Midiri and Vinci, {Sergio L.} and Rosa Musolino and Francesca Granata and Antonio Pitrone and Enricomaria Mormina and Gianmarco Bernava and Alessandro Calamuneri and Marcello Longo and Rosario Papa and Giuseppe Centorrino and Agostino Tessitore and Caragliano, {Antonio A.}",
year = "2018",
language = "English",
pages = "1--9",
journal = "Radiologia Medica",
issn = "0033-8362",
publisher = "Springer-Verlag Italia",

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TY - JOUR

T1 - MRI patient selection for endovascular thrombectomy in acute ischemic stroke: correlation between pretreatment diffusion weighted imaging and outcome scores

AU - Vernuccio, Federica

AU - Midiri, Federico

AU - Vinci, Sergio L.

AU - Musolino, Rosa

AU - Granata, Francesca

AU - Pitrone, Antonio

AU - Mormina, Enricomaria

AU - Bernava, Gianmarco

AU - Calamuneri, Alessandro

AU - Longo, Marcello

AU - Papa, Rosario

AU - Centorrino, Giuseppe

AU - Tessitore, Agostino

AU - Caragliano, Antonio A.

PY - 2018

Y1 - 2018

N2 - 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.

AB - 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.

UR - http://hdl.handle.net/10447/288666

UR - http://link.springer.com/journal/11547

M3 - Article

SP - 1

EP - 9

JO - Radiologia Medica

JF - Radiologia Medica

SN - 0033-8362

ER -