ASPECTS-based reperfusion status on arterial spin labeling is associated with clinical outcome in acute ischemic stroke patients

被引：36

作者：

Yu, Songlin ^{[1
,2
]}

Ma, Samantha J. ^{[3
]}

Liebeskind, David S. ^{[1
,4
]}

Yu, Dandan ^{[5
]}

Li, Ning ^{[6
]}

Qiao, Xin J. ^{[7
]}

Shao, Xingfeng ^{[3
]}

Yan, Lirong ^{[3
]}

Yoo, Bryan ^{[7
]}

Scalzo, Fabien ^{[1
,4
]}

Hinman, Jason D. ^{[1
]}

Sharma, Latisha K. ^{[1
]}

Rao, Neal ^{[1
]}

Jahan, Reza ^{[8
,9
]}

Tateshima, Satoshi ^{[2
]}

Duckwiler, Gary R. ^{[8
,9
]}

Saver, Jeffrey L. ^{[1
]}

Salamon, Noriko ^{[7
]}

Wang, Danny J. J. ^{[1
,3
]}

机构：

[1] UCLA, Dept Neurol, Los Angeles, CA 90024 USA

[2] Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China

[3] Univ Southern Calif, Stevens Neuroimaging & Informat Inst, Dept Neurol, Los Angeles, CA 90089 USA

[4] UCLA, Neurovasc Imaging Res Core, Los Angeles, CA USA

[5] Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Neurointens Care Unit, Beijing, Peoples R China

[6] UCLA, Dept Biomath, Los Angeles, CA USA

[7] UCLA, Dept Radiol, Los Angeles, CA USA

[8] UCLA, Div Intervent Neuroradiol, Los Angeles, CA USA

[9] UCLA, Stroke Ctr, Los Angeles, CA USA

来源：

JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM | 2018年 / 38卷 / 03期

基金：

美国国家卫生研究院;

关键词：

Acute ischemic stroke; arterial spin labelling; recanalization; reperfusion; reperfusion injury; COMPUTED-TOMOGRAPHY SCORE; HEMORRHAGIC TRANSFORMATION; POSTISCHEMIC HYPERPERFUSION; THROMBOLYTIC THERAPY; CEREBRAL-ARTERY; PERFUSION MRI; RECANALIZATION; DIFFUSION; BRAIN; TRIAL;

D O I：

10.1177/0271678X17697339

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The purpose of this study was to develop and evaluate a scoring system for assessing reperfusion status based on arterial spin labeled (ASL) perfusion MRI in acute ischemic stroke (AIS) patients receiving thrombolysis and/or endovascular treatment. Pseudo-continuous ASL with background suppressed 3D GRASE was acquired along with DWI in 90 patients within 24 h post-treatment. An automatic reperfusion scoring system (auto-RPS) was devised based on the Alberta Stroke Program Early CT Score (ASPECTS) template, and compared with manual RPS and DWI-ASPECTS. TICI (thrombolysis in cerebral infarction) scores were graded in 48 patients who received endovascular treatment. Favorable outcomes were defined by a modified Rankin Scale score of 0-2 at three months. Auto-RPS was positively correlated with DWI-ASPECTS (r = 0.6, P < 0.001) and was on average 1 point lower than DWI-ASPECTS (P < 0.001). The area under the receiver operating characteristic curve for discriminating poor functional outcome (n = 90) was 0.75 (95% CI, 0.64-0.86) for manual RPS, 0.85 (95% CI, 0.76-0.94) for auto-RPS, and 0.81 (95% CI, 0.71-0.90) for DWI-ASPECTS. Multiple logistic regression analysis in the TICI-graded patients (n = 48) showed that auto-RPS is highly associated with functional outcome (OR = 25.2, 95% CI 4.02-496, P < 0.01). Post treatment auto-RPS within 24 h provides a useful tool to predict functional outcome in AIS patients.

引用

页码：382 / 392

页数：11

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