Key result
DWI-ASPECTS correlates strongly with infarct volume, but intermediate scores show wide volume variability.
Observational (n=330)
Effect estimate: ρ=-0.82
BACKGROUND AND PURPOSE: The extent of diffusion lesion on pretreatment imaging is a risk factor for poor outcome and hemorrhagic transformation after thrombolysis, and volumes of 70 to 100 mL have been advocated as cut-offs. However, estimating diffusion-weighted imaging (DWI) lesion volume (VolDWI) in the acute setting may be cumbersome. We aimed to determine whether the DWI-Alberta Stroke Program Early CT Score (DWI-ASPECTS) can substitute for VolDWI. METHODS: DWI-ASPECTS and VolDWI were measured retrospectively on pretreatment MRI (median onset-to-MRI delay=122 minutes) in 330 consecutively treated patients with middle cerebral artery stroke. RESULTS: DWI-ASPECTS and VolDWI were strongly correlated (ρ=-0.82), but each DWI-ASPECTS point corresponded to a wide range of VolDWI. All patients with DWI-ASPECTS≥7 (n=207) had VolDWI<70 mL, whereas 32 of the 34 patients with DWI-ASPECTS<4 had VolDWI>100 mL. However, intermediate DWI-ASPECTS (4-6; n=89) corresponded to highly variable VolDWI (median, 66 mL; interquartile range, 40-98). CONCLUSIONS: Although each DWI-ASPECTS point corresponds to a wide range of volumes, DWI-ASPECTS<4 or ≥7 may be used as reliable surrogates of VolDWI>100 or <70 mL, respectively.
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Margerie‐Mellon et al. (2013) conducted an observational in Acute middle cerebral artery stroke (n=330). DWI-ASPECTS vs. DWI lesion volume (VolDWI) was evaluated on Correlation between DWI-ASPECTS and VolDWI (ρ=-0.82). DWI-ASPECTS strongly correlated with VolDWI (ρ=-0.82); scores <4 and ≥7 reliably predicted volumes >100 mL and <70 mL, but intermediate scores (4-6) had highly variable volumes.
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