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Clot burden score on admission T2*-MRI predicts recanalization in acute stroke
- Source :
- Stroke. 44(7)
- Publication Year :
- 2013
-
Abstract
- Background and Purpose— To propose a T2*-MR adaptation of the computed tomography angiography-clot burden score (CBS), and assess its value as predictor of 24-hour recanalization and clinical outcome in anterior circulation stroke treated by intravenous thrombolysis ≤4.5 hours from onset. Methods— Two independent observers retrospectively analyzed pretreatment T2* images for evaluation of clot burden, using a 10-point scale T2*-CBS. Three points are subtracted for susceptibility vessel sign in the supraclinoid internal carotid artery, 2 points each for susceptibility vessel sign in the proximal and distal part of middle cerebral artery, and 1 point each for susceptibility vessel sign in middle cerebral artery branches (with a maximum of 2 points) and for susceptibility vessel sign in anterior cerebral artery. Associations with 24-hour recanalization and favorable outcome (3-month modified Rankin Scale score, ≤2) were assessed in multivariate analyses. Results— We analyzed 184 consecutive patients (mean age, 67 years) with median (interquartile range) admission National Institutes of Health Stroke Scale score and onset-to-treatment time of 15 (9–19) and 151 (120–185) minutes, respectively. The intraclass correlation for T2*-CBS between observers was 0.97 (95% confidence interval, 0.97–0.98). In multivariate analyses, T2*-CBS >6 was significantly associated with 24-hour recanalization (adjusted odds ratio, 5.1 [1.9–13.5]; P =0.001) or with favorable outcome (adjusted odds ratio, 4.2 [1.7–10.8]; P =0.003). Conclusions— T2*-CBS, a new reproducible semiquantitative score adapted from the computed tomography angiography-CBS, is associated with 24-hour recanalization and 3-month outcome after intravenous thrombolysis. This score needs external validation and could be useful to identify poor responders to intravenous thrombolysis.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Infarction
Severity of Illness Index
Modified Rankin Scale
Predictive Value of Tests
medicine.artery
medicine
Anterior cerebral artery
Humans
Thrombolytic Therapy
Thrombus
Stroke
Aged
Advanced and Specialized Nursing
Aged, 80 and over
business.industry
Thrombolysis
Cerebral Arteries
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Treatment Outcome
Tissue Plasminogen Activator
Middle cerebral artery
Female
Neurology (clinical)
Radiology
Internal carotid artery
Cardiology and Cardiovascular Medicine
business
Tomography, X-Ray Computed
Subjects
Details
- ISSN :
- 15244628
- Volume :
- 44
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- Stroke
- Accession number :
- edsair.doi.dedup.....14e8b5a400494c1c72324b528d813fd2