CORRELATION OF DIFFUSION WEIGHTED MR DETERMINED INFARCT VOLUME WITH ALBERTA STROKE PROGRAM EARLY COMPUTED TOMOGRAPHY SCORE IN ACUTE STROKE PROGNOSIS

Abstract

AIMS AND OBJECTIVES: To correlate the Diffusion MRI assessed infarct volume with the ASPECT Score to prognosticate clinical outcome in patients of acute stroke. METHOD AND MATERIALS: This was a cross sectional study comprising 36 patients of acute stroke. Diffusion weighted MR was obtained at b values of 0,500 & 1000 on Siemens Magnetom Skyra 3 Tesla scanner. Diffusion restriction on b=1000 image was measured with VOI tool using manual contouring in each slice. Volume was calculated using the formula (Area x slice thickness) after summating the infarct area measured in each slice. ASPECT Score was assessed on CT in each patient at the time of admission of the patient. Correlation of the infarct volume with ASPECTS was done using student t-test with p < 0.05 considered statistically signicant. ROC curve was used to predict cut off of volume of infarct & ASPECTS predicting adverse patient outcome. RESULTS: There was a statistically signicant inverse correlation between the volume of infarct and ASPECTS (p=0.001; r=-0.844). The AUC for a cut-off of 115 cc of the volume of infarct in predicting adverse patient outcome was 0.931 whereas that for ASPECT Scale of 6 was 0.931. CONCLUSION: Infarct volume correlates well with ASPECT Score, both serving as prognostic tools in predicting patient outcome in acute stroke and having comparable efcacy in predicting prognosis. BACKGROUND: Infarct volume and CT ASPECT Score are resourceful parameters in predicting patient prognosis. Limited studies have been done in the Indian population correlating the Volume of infarct and the CT ASPECT Scale.