Validity of Acute Stroke Lesion Volume Estimation by Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomographic Score Depends on Lesion Location in 496 Patients With Middle Cerebral Artery Stroke
Identifieur interne : 003E95 ( Main/Exploration ); précédent : 003E94; suivant : 003E96Validity of Acute Stroke Lesion Volume Estimation by Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomographic Score Depends on Lesion Location in 496 Patients With Middle Cerebral Artery Stroke
Auteurs : Julian Schröder [Allemagne] ; Bastian Cheng [Allemagne] ; Martin Ebinger [Allemagne] ; Martin Köhrmann [Allemagne] ; ONA WU [États-Unis] ; Dong-Wha Kang [Corée du Sud] ; David S. Liebeskind [États-Unis] ; Thomas Tourdias [France] ; Oliver C. Singer [Allemagne] ; Soren Christensen [Australie] ; Bruce Campbell [Australie] ; Marie Luby [États-Unis] ; Steven Warach [États-Unis] ; Jens Fiehler [Allemagne] ; Jochen B. Fiebach [Allemagne] ; Christian Gerloff [Allemagne] ; Götz Thomalla [Allemagne]Source :
- Stroke : (1970) [ 0039-2499 ] ; 2014.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Infarctus du territoire de l'artère cérébrale moyenne.
- imagerie diagnostique : Infarctus du territoire de l'artère cérébrale moyenne.
- Pascal (Inist)
- Accident cérébrovasculaire, Adulte d'âge moyen, Femelle, Humains, Imagerie par résonance magnétique de diffusion, Ischémie de l'encéphale, Mâle, Pathologie du système nerveux, Pathologie cérébrovasculaire, Sujet âgé, Tomodensitométrie, Volume systolique, Estimation, Imagerie RMN, Tomodensitométrie, Homme, Artère cérébrale moyenne, Hémodynamique, Imagerie de diffusion.
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Aged, Brain ischemia, Cerebrovascular disease, Computerized axial tomography, Diffusion Magnetic Resonance Imaging, Diffusion imaging, Estimation, Female, Hemodynamics, Human, Humans, Infarction, Middle Cerebral Artery (diagnostic imaging), Infarction, Middle Cerebral Artery (pathology), Male, Middle Aged, Middle cerebral artery, Nervous system diseases, Nuclear magnetic resonance imaging, Stroke, Systolic volume, Tomography, X-Ray Computed.
- MESH :
- diagnostic imaging : Infarction, Middle Cerebral Artery.
- pathology : Infarction, Middle Cerebral Artery.
- Aged, Diffusion Magnetic Resonance Imaging, Female, Humans, Male, Middle Aged, Tomography, X-Ray Computed.
Abstract
Background and Purpose-Alberta Stroke Program Early Computed Tomographic Score (ASPECTS) has been used to estimate diffusion-weighted imaging (DWI) lesion volume in acute stroke. We aimed to assess correlations of DWI-ASPECTS with lesion volume in different middle cerebral artery (MCA) subregions and reproduce existing ASPECTS thresholds of a malignant profile defined by lesion volume ≥100 mL. Methods-We analyzed data of patients with MCA stroke from a prospective observational study of DWI and fluid-attenuated inversion recovery in acute stroke. DWI-ASPECTS and lesion volume were calculated. The population was divided into subgroups based on lesion localization (superficial MCA territory, deep MCA territory, or both). Correlation of ASPECTS and infarct volume was calculated, and receiver-operating characteristics curve analysis was performed to identify the optimal ASPECTS threshold for ≥100-mL lesion volume. Results-A total of 496 patients were included. There was a significant negative correlation between ASPECTS and DWI lesion volume (r=0.78; P<0.0001). With regards to lesion localization, correlation was weaker in deep MCA region (r=-0.19; P=0.038) when compared with superficial (r=-0.72; P<0.001) or combined superficial and deep MCA lesions (r=-0.72; P<0.001). Receiver-operating characteristics analysis revealed ASPECTS≤6 as best cutoff to identify ≥100-mL DWI lesion volume; however, positive predictive value was low (0.35). Conclusions-ASPECTS has limitations when lesion location is not considered. Identification of patients with malignant profile by DWI-ASPECTS may be unreliable. ASPECTS may be a useful tool for the evaluation of noncontrast computed tomography. However, if MRI is used, ASPECTS seems dispensable because lesion volume can easily be quantified on DWI maps.
Url:
Affiliations:
- Allemagne, Australie, Corée du Sud, France, États-Unis
- Aquitaine, Bavière, Berlin, Californie, District de Darmstadt, District de Moyenne-Franconie, Hambourg, Hesse (Land), Massachusetts, Nouvelle-Aquitaine, Région capitale de Séoul, Victoria (État)
- Berlin, Bordeaux, Boston, Erlangen, Francfort-sur-le-Main, Hambourg, Los Angeles, Melbourne, Séoul
- Université de Bordeaux, Université de Melbourne
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Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Validity of Acute Stroke Lesion Volume Estimation by Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomographic Score Depends on Lesion Location in 496 Patients With Middle Cerebral Artery Stroke</title>
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<affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Department of Neurology, University of California</s1>
<s2>Los Angeles</s2>
<s3>USA</s3>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><settlement type="city">Los Angeles</settlement>
<region type="state">Californie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Tourdias, Thomas" sort="Tourdias, Thomas" uniqKey="Tourdias T" first="Thomas" last="Tourdias">Thomas Tourdias</name>
<affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Université de Bordeaux, CHU de Bordeaux, Service de NeuroImagerie Diagnostique de Thérapeutique</s1>
<s2>Bordeaux</s2>
<s3>FRA</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Nouvelle-Aquitaine</region>
<region type="old region">Aquitaine</region>
<settlement type="city">Bordeaux</settlement>
<settlement type="city">Bordeaux</settlement>
</placeName>
<orgName type="university">Université de Bordeaux</orgName>
</affiliation>
</author>
<author><name sortKey="Singer, Oliver C" sort="Singer, Oliver C" uniqKey="Singer O" first="Oliver C." last="Singer">Oliver C. Singer</name>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Klinik für Neurologie, Universitätsklinikum Frankfurt</s1>
<s2>Frankfurt</s2>
<s3>DEU</s3>
<sZ>9 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
<placeName><region type="land" nuts="1">Hesse (Land)</region>
<region type="district" nuts="2">District de Darmstadt</region>
<settlement type="city">Francfort-sur-le-Main</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Christensen, Soren" sort="Christensen, Soren" uniqKey="Christensen S" first="Soren" last="Christensen">Soren Christensen</name>
<affiliation wicri:level="4"><inist:fA14 i1="09"><s1>Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne</s1>
<s2>Parkville</s2>
<s3>AUS</s3>
<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Australie</country>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
<orgName type="university">Université de Melbourne</orgName>
</affiliation>
</author>
<author><name sortKey="Campbell, Bruce" sort="Campbell, Bruce" uniqKey="Campbell B" first="Bruce" last="Campbell">Bruce Campbell</name>
<affiliation wicri:level="4"><inist:fA14 i1="09"><s1>Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne</s1>
<s2>Parkville</s2>
<s3>AUS</s3>
<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Australie</country>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
<orgName type="university">Université de Melbourne</orgName>
</affiliation>
</author>
<author><name sortKey="Luby, Marie" sort="Luby, Marie" uniqKey="Luby M" first="Marie" last="Luby">Marie Luby</name>
<affiliation wicri:level="1"><inist:fA14 i1="10"><s1>National Institute of Neurological Disorders and Stroke</s1>
<s2>Bethesda, MD</s2>
<s3>USA</s3>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>National Institute of Neurological Disorders and Stroke</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Warach, Steven" sort="Warach, Steven" uniqKey="Warach S" first="Steven" last="Warach">Steven Warach</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Department of Neurology and Neurotherapeutics, Seton/UT Southwestern Clinical Research Institute of Austin, UT Southwestern Medical Center</s1>
<s2>Austin, TX</s2>
<s3>USA</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Austin, TX</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Fiehler, Jens" sort="Fiehler, Jens" uniqKey="Fiehler J" first="Jens" last="Fiehler">Jens Fiehler</name>
<affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention, Unversitätsklinikum Hamburg-Eppendorf</s1>
<s2>Hamburg</s2>
<s3>DEU</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
<placeName><settlement type="city">Hambourg</settlement>
<region type="land" nuts="2">Hambourg</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Fiebach, Jochen B" sort="Fiebach, Jochen B" uniqKey="Fiebach J" first="Jochen B." last="Fiebach">Jochen B. Fiebach</name>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centrum für Schlaganfallforschung Berlin, Charité-Universitätsmedizin Berlin</s1>
<s2>Berlin</s2>
<s3>DEU</s3>
<sZ>3 aut.</sZ>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
<placeName><region type="land" nuts="3">Berlin</region>
<settlement type="city">Berlin</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Gerloff, Christian" sort="Gerloff, Christian" uniqKey="Gerloff C" first="Christian" last="Gerloff">Christian Gerloff</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf</s1>
<s2>Hamburg</s2>
<s3>DEU</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>16 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
<placeName><settlement type="city">Hambourg</settlement>
<region type="land" nuts="2">Hambourg</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Thomalla, Gotz" sort="Thomalla, Gotz" uniqKey="Thomalla G" first="Götz" last="Thomalla">Götz Thomalla</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf</s1>
<s2>Hamburg</s2>
<s3>DEU</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>16 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
<placeName><settlement type="city">Hambourg</settlement>
<region type="land" nuts="2">Hambourg</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Stroke : (1970)</title>
<title level="j" type="abbreviated">Stroke : (1970)</title>
<idno type="ISSN">0039-2499</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Stroke : (1970)</title>
<title level="j" type="abbreviated">Stroke : (1970)</title>
<idno type="ISSN">0039-2499</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Brain ischemia</term>
<term>Cerebrovascular disease</term>
<term>Computerized axial tomography</term>
<term>Diffusion Magnetic Resonance Imaging</term>
<term>Diffusion imaging</term>
<term>Estimation</term>
<term>Female</term>
<term>Hemodynamics</term>
<term>Human</term>
<term>Humans</term>
<term>Infarction, Middle Cerebral Artery (diagnostic imaging)</term>
<term>Infarction, Middle Cerebral Artery (pathology)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Middle cerebral artery</term>
<term>Nervous system diseases</term>
<term>Nuclear magnetic resonance imaging</term>
<term>Stroke</term>
<term>Systolic volume</term>
<term>Tomography, X-Ray Computed</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Femelle</term>
<term>Humains</term>
<term>Imagerie par résonance magnétique de diffusion</term>
<term>Infarctus du territoire de l'artère cérébrale moyenne (anatomopathologie)</term>
<term>Infarctus du territoire de l'artère cérébrale moyenne (imagerie diagnostique)</term>
<term>Mâle</term>
<term>Sujet âgé</term>
<term>Tomodensitométrie</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Infarctus du territoire de l'artère cérébrale moyenne</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Infarction, Middle Cerebral Artery</term>
</keywords>
<keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Infarctus du territoire de l'artère cérébrale moyenne</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Infarction, Middle Cerebral Artery</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Diffusion Magnetic Resonance Imaging</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Tomography, X-Ray Computed</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Accident cérébrovasculaire</term>
<term>Adulte d'âge moyen</term>
<term>Femelle</term>
<term>Humains</term>
<term>Imagerie par résonance magnétique de diffusion</term>
<term>Ischémie de l'encéphale</term>
<term>Mâle</term>
<term>Pathologie du système nerveux</term>
<term>Pathologie cérébrovasculaire</term>
<term>Sujet âgé</term>
<term>Tomodensitométrie</term>
<term>Volume systolique</term>
<term>Estimation</term>
<term>Imagerie RMN</term>
<term>Tomodensitométrie</term>
<term>Homme</term>
<term>Artère cérébrale moyenne</term>
<term>Hémodynamique</term>
<term>Imagerie de diffusion</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background and Purpose-Alberta Stroke Program Early Computed Tomographic Score (ASPECTS) has been used to estimate diffusion-weighted imaging (DWI) lesion volume in acute stroke. We aimed to assess correlations of DWI-ASPECTS with lesion volume in different middle cerebral artery (MCA) subregions and reproduce existing ASPECTS thresholds of a malignant profile defined by lesion volume ≥100 mL. Methods-We analyzed data of patients with MCA stroke from a prospective observational study of DWI and fluid-attenuated inversion recovery in acute stroke. DWI-ASPECTS and lesion volume were calculated. The population was divided into subgroups based on lesion localization (superficial MCA territory, deep MCA territory, or both). Correlation of ASPECTS and infarct volume was calculated, and receiver-operating characteristics curve analysis was performed to identify the optimal ASPECTS threshold for ≥100-mL lesion volume. Results-A total of 496 patients were included. There was a significant negative correlation between ASPECTS and DWI lesion volume (r=0.78; P<0.0001). With regards to lesion localization, correlation was weaker in deep MCA region (r=-0.19; P=0.038) when compared with superficial (r=-0.72; P<0.001) or combined superficial and deep MCA lesions (r=-0.72; P<0.001). Receiver-operating characteristics analysis revealed ASPECTS≤6 as best cutoff to identify ≥100-mL DWI lesion volume; however, positive predictive value was low (0.35). Conclusions-ASPECTS has limitations when lesion location is not considered. Identification of patients with malignant profile by DWI-ASPECTS may be unreliable. ASPECTS may be a useful tool for the evaluation of noncontrast computed tomography. However, if MRI is used, ASPECTS seems dispensable because lesion volume can easily be quantified on DWI maps.</div>
</front>
</TEI>
<affiliations><list><country><li>Allemagne</li>
<li>Australie</li>
<li>Corée du Sud</li>
<li>France</li>
<li>États-Unis</li>
</country>
<region><li>Aquitaine</li>
<li>Bavière</li>
<li>Berlin</li>
<li>Californie</li>
<li>District de Darmstadt</li>
<li>District de Moyenne-Franconie</li>
<li>Hambourg</li>
<li>Hesse (Land)</li>
<li>Massachusetts</li>
<li>Nouvelle-Aquitaine</li>
<li>Région capitale de Séoul</li>
<li>Victoria (État)</li>
</region>
<settlement><li>Berlin</li>
<li>Bordeaux</li>
<li>Boston</li>
<li>Erlangen</li>
<li>Francfort-sur-le-Main</li>
<li>Hambourg</li>
<li>Los Angeles</li>
<li>Melbourne</li>
<li>Séoul</li>
</settlement>
<orgName><li>Université de Bordeaux</li>
<li>Université de Melbourne</li>
</orgName>
</list>
<tree><country name="Allemagne"><region name="Hambourg"><name sortKey="Schroder, Julian" sort="Schroder, Julian" uniqKey="Schroder J" first="Julian" last="Schröder">Julian Schröder</name>
</region>
<name sortKey="Cheng, Bastian" sort="Cheng, Bastian" uniqKey="Cheng B" first="Bastian" last="Cheng">Bastian Cheng</name>
<name sortKey="Ebinger, Martin" sort="Ebinger, Martin" uniqKey="Ebinger M" first="Martin" last="Ebinger">Martin Ebinger</name>
<name sortKey="Fiebach, Jochen B" sort="Fiebach, Jochen B" uniqKey="Fiebach J" first="Jochen B." last="Fiebach">Jochen B. Fiebach</name>
<name sortKey="Fiehler, Jens" sort="Fiehler, Jens" uniqKey="Fiehler J" first="Jens" last="Fiehler">Jens Fiehler</name>
<name sortKey="Gerloff, Christian" sort="Gerloff, Christian" uniqKey="Gerloff C" first="Christian" last="Gerloff">Christian Gerloff</name>
<name sortKey="Kohrmann, Martin" sort="Kohrmann, Martin" uniqKey="Kohrmann M" first="Martin" last="Köhrmann">Martin Köhrmann</name>
<name sortKey="Singer, Oliver C" sort="Singer, Oliver C" uniqKey="Singer O" first="Oliver C." last="Singer">Oliver C. Singer</name>
<name sortKey="Thomalla, Gotz" sort="Thomalla, Gotz" uniqKey="Thomalla G" first="Götz" last="Thomalla">Götz Thomalla</name>
</country>
<country name="États-Unis"><region name="Massachusetts"><name sortKey="Ona Wu" sort="Ona Wu" uniqKey="Ona Wu" last="Ona Wu">ONA WU</name>
</region>
<name sortKey="Liebeskind, David S" sort="Liebeskind, David S" uniqKey="Liebeskind D" first="David S." last="Liebeskind">David S. Liebeskind</name>
<name sortKey="Luby, Marie" sort="Luby, Marie" uniqKey="Luby M" first="Marie" last="Luby">Marie Luby</name>
<name sortKey="Warach, Steven" sort="Warach, Steven" uniqKey="Warach S" first="Steven" last="Warach">Steven Warach</name>
</country>
<country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Kang, Dong Wha" sort="Kang, Dong Wha" uniqKey="Kang D" first="Dong-Wha" last="Kang">Dong-Wha Kang</name>
</region>
</country>
<country name="France"><region name="Nouvelle-Aquitaine"><name sortKey="Tourdias, Thomas" sort="Tourdias, Thomas" uniqKey="Tourdias T" first="Thomas" last="Tourdias">Thomas Tourdias</name>
</region>
</country>
<country name="Australie"><region name="Victoria (État)"><name sortKey="Christensen, Soren" sort="Christensen, Soren" uniqKey="Christensen S" first="Soren" last="Christensen">Soren Christensen</name>
</region>
<name sortKey="Campbell, Bruce" sort="Campbell, Bruce" uniqKey="Campbell B" first="Bruce" last="Campbell">Bruce Campbell</name>
</country>
</tree>
</affiliations>
</record>
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