DWI-ASPECTS predicts collateral circulation compensation in patients with acute middle cerebral artery infarction after intravenous thrombolysis
10.3969/j.issn.1006-5725.2018.06.010
- VernacularTitle:DWI-ASPECTS预测急性期大脑中动脉供血区梗死静脉溶栓患者侧支循环代偿的价值
- Author:
Yuanyuan MENG
1
;
Deyun WU
;
Yingchun LIU
;
Xiaohui CHEN
Author Information
1. 胜利油田中心医院
- Keywords:
stroke;
intravenous thrombolysis;
middle cerebral artery;
collateral circulation;
DWI-ASPECT score
- From:
The Journal of Practical Medicine
2018;34(6):912-916
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of Alberta Stroke Program Early CT Score on diffusion weight-ed imaging(DWI-ASPECTS)in predicting the leptomeningeal collateral circulation(LMA)compensation of isch-emic stroke with middle cerebral artery stenosis or occlusion after intravenous thrombolysis. Methods A total of 178 patients with ischemic stroke confirmed as severe middle cerebral artery stenosis or occlusion by imaging were enrolled in the study.All the patients were treated by rt-PA intravenous thrombolysis.The baseline clinical date, DWI-ASPECTS,mRS and NIHSS were collected. LMA was assessed by cranio-cervical CTA. Results Compared with the poor collateral circulation group,the triglyceride level and DWI-ASPECTS were significantly increased in good collateral circulation group(P<0.05).The proportion of hypertension,NIHSS score,mRS score in good col-lateral circulation group were significantly lower than those in the poor collateral circulation group(P < 0.05). Compared with the poor collateral circulation group,insula,the ASPECTS areas M1 to M4,M6 and insula showed significantly fewer infarctions in good collateral circulation group(P<0.05).ROC analysis showed the area under ROC curve(AUC)of DWI-ASPECTS to predict LMA compensation were 0.932,the cutoff point of DWI-ASPECTS was 7.5.the sensitivity and specificity were 81.% and 94.1%.Conclusions The tissue protective role of good lepto-meningeal collateralization seems to be more pronounced in cortical and subcortical areas M1 to M4,M6 and the in-sula.DWI-ASPECTS can effectively predict the collateral circulation compensation in patients with acute middle ce-rebral artery infarction.
