Utility of Minimum Apparent Diffusion Coefficient Ratios in Alberta Stroke Program Early CT Score Regions for Deciding on Stroke Therapy

Yuta Maetani, Masahiro Nakamori, Eiji Imamura, Yosuke Ishii, Hiroshi Aihara, Yoshio Suyama, Shinichi Wakabayashi, Hirofumi Maruyama

Research output: Contribution to journalArticle

Abstract

Background and Purpose: Therapeutic indications for recombinant tissue plasminogen activator therapy and endovascular therapy need to be assessed for patients with hyperacute ischemic stroke. We investigated the relationship between the minimum apparent diffusion coefficient ratios in each Alberta Stroke Program Early CT Score region and reversible lesion in patients with hyperacute ischemic stroke receiving recombinant tissue plasminogen activator therapy and/or treated with endovascular therapy. Materials and Methods: We retrospectively evaluated 29 patients with first ischemic stroke due to stenosis/occlusion of the internal carotid artery or horizontal portion of the middle cerebral artery that was successfully recanalized by recombinant tissue plasminogen activator therapy and/or treated with endovascular therapy. We measured the minimum apparent diffusion coefficient value in each Alberta Stroke Program Early CT Score region (11 regions) and calculated the ratio. Results: There was a significant difference in minimum apparent diffusion coefficient ratios between regions that included and did not include infarction (P <.0001), which were distinguishable with a cutoff value of.808 (area under the curve =.80, P <.001). A statistical difference in the proportion of infarction with the cutoff value was observed between patients treated with endovascular therapy and receiving recombinant tissue plasminogen activator therapy alone (9.9% versus 24.6%, P =.0041) and between patients with affected middle cerebral and internal carotid arteries (7.0% versus 24.2%, P =.0002). The lowest apparent diffusion coefficient ratio was associated with the time to recombinant tissue plasminogen activator injection. Conclusions: Minimum apparent diffusion coefficient ratios in Alberta Stroke Program Early CT Score regions are useful in predicting therapeutic effect.

Original languageEnglish
Pages (from-to)1371-1380
Number of pages10
JournalJournal of Stroke and Cerebrovascular Diseases
Volume28
Issue number5
DOIs
Publication statusPublished - 05-2019
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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