Dongmei Wang, Peng Hao, Mengyao Wang, Zhenzhou Lin, Liang Zhou, Zusen Fan, Yue Pan, Xiaomei Zhang, Suyue Pan, Zhong J I
Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2020 Jan 30;40(1):1-5. doi: 10.12122/j.issn.1673-4254.2020.01.01.
To retrospectively analyze the outcomes of wake-up stroke (WUS) patients with occlusion of large vessel occlusion (LVO), who were selected for mechanical thrombectomy according to the mismatch of Alberta Stroke Program Early CT Score (ASPECTS) based on arterial spin labeling (ASL) and diffusion-weighted image (DWI) on admission magnetic resonance (MR) scans.
Twelve consecutive WUS patients with acute LVO of the anterior circulation undergoing MR scans with ASL and DWI prior to thrombectomy were retrospectively evaluated. The mismatch of ASPECTS was defined as the difference between ASL-ASPECTS and DWI-ASPECTS, and a higher score indicates a greater mismatch.
The procedures led to successful reperfusion in all the cases (Thrombolysis in Cerebral Infarction Grade 2b-3). Eleven patients (91.7%) had significantly decreased National Institute of Health Stroke scale (NIHSS) score at discharge.AmRS score of ≤2 at 90 days was achieved in 8 of the 12 patients (66.7%).
The mismatch between ASPECTS assessed based on ASL and DWI can detect a true mismatch in patients with acute LVO of the anterior circulation, and can be used for rapid screening of patients eligible for thrombectomy.
回顾性分析大血管闭塞（LVO）的醒后卒中（WUS）患者的治疗结果，这些患者根据入院磁共振（MR）扫描时基于动脉自旋标记（ASL）和弥散加权成像（DWI）的阿尔伯塔卒中项目早期CT评分（ASPECTS）不匹配被选入机械取栓治疗。
回顾性评估12例连续的前循环急性LVO的WUS患者，这些患者在取栓术前接受了ASL和DWI的MR扫描。ASPECTS不匹配定义为ASL-ASPECTS与DWI-ASPECTS之间的差异，分数越高表明不匹配越大。
所有病例手术均实现成功再灌注（脑梗死溶栓分级2b-3级）。11例患者（91.7%）出院时美国国立卫生研究院卒中量表（NIHSS）评分显著降低。12例患者中有8例（66.7%）在90天时达到改良Rankin量表（mRS）评分≤2分。
基于ASL和DWI评估的ASPECTS之间的不匹配可检测前循环急性LVO患者的真正不匹配，并可用于快速筛查适合取栓治疗的患者。
