Role of DWI-ASPECTS in assessing prognosis of patients with acute cerebral infarction after intravenous thrombolysis

Abstract

Objective To evaluate the role of Alberta stroke program early CT scale(ASPECTS)on diffusion weighted imaging(DWI)in predicting functional outcomes of patients with acute anterior circulation cerebral infarction after intravenous thrombolysis. Methods Forty-eight patients with acute anterior circulation cerebral infarction after intravenous thrombolysis, admitted to our hospital from March 2012 to July 2014, were chosen. According to modified Rankin scale(mRS)scores, the favorable(F)and unfavorable(U)outcome groups were defined. The clinical data, scores of DWI-ASPECTS after thrombolysis and Logistic variables were analyzed. A multivariate Logistic regression analysis was used to identify variable influencing clinical outcomes. Results After 30 and 90 days treatment, as compared with patients in U group, patients in F group had significantly lower national institutes of health stroke scale(NIHSS)scores, and significantly higher DWI-ASPECTS scores(P<0.05). Logistic regression analysis showed that NIHSS scores(OR=1.359, 95% CI= 1.132-1.633, P=0.001; OR=1.381, 95% CI: 1.130-1.688, P=0.002)and DWI-ASPECTS scores(OR= 0.583, 95% CI=0.432-0.789, P=0.000; OR=0.545, 95% CI=0.387-0.767, P=0.001)were both the independent predictors 30 and 90 days after thrombolysis. Receiver operating characteristic analysis showed that the optimal cutoff point of DWI-ASPECTS to predict the functional outcome was set as 7, the areas, enjoying the biggest, were 0.874(P<0.05, sensitivity 70.4% and specificity 85.7%)and 0.902(P<0.05, sensitivity 77.8% and specificity 91.7%), respectively, 30 and 90 days after thrombolysis. Conclusion DWI-ASPECTS is of great value in assessing functional outcome after thrombolysis in acute anterior circulation cerebral infarction; its evaluation value is better in those 90 days after thrombolysis than in those 30 days after thrombolysis. Key words: Cerebral infarction; Alberta stroke program early CT scale; Intravenous thrombolysis; Prognosis