Prediction of early XXXX using diffusion- and perfusion-weighted imaging in hyperacute @entity2500 .

@entity1 @entity64 @entity353 @entity2500 @entity16 @entity3538 @entity1188 @entity432 @entity385
BACKGROUND AND PURPOSE: Early @entity16 (END) occurs in approximately one third of all @entity385 @entity1 and is associated with a poor outcome. Our study sought to assess the value of ultra-early MRI in the prediction of END in @entity64 @entity1 . METHODS: Between August 1999 and November 2001, 38 @entity64 @entity1 with a proven @entity2500 (ICA) occlusion on MR angiography underwent perfusion-weighted imaging (PWI) and @entity353 ( @entity353 ) within 6 hours after onset, and 30 fulfilled all inclusion criteria. Control @entity353 and MR angiography were performed between days 3 and 5. Cranial CT was performed to rule out hemorrhagic transformation. Vascular risk factors, temperature, blood pressure, glycemia, and blood count were assessed on admission. National Institutes of Health @entity64 Scale (NIHSS) scores were obtained at baseline and at 6, 12, 24, and 48 hours. At the same time points, transcranial Doppler (TCD) examinations were conducted to assess arterial recanalization. END was defined as an increase in the NIHSS score >4. A logistic regression model was applied to detect independent predictors of END. The Kruskal-Wallis test was used to evaluate the relationship between @entity1188 growth and duration of @entity432 . RESULTS: Initial MR angiography showed an occlusion of @entity3538 in 7 @entity1 (23.3%), of proximal MCA in 14 (46.6%), and of distal MCA in the remaining 9 (30%). A PWI- @entity353 mismatch >20% was observed in 28 @entity1 (93.3%). END occurred in 7 @entity1 (23.3%). Baseline NIHSS score (P=0.05), proximal site of occlusion (P=0.002), initial @entity353 (P=0.002) and PWI (P=0.003) volumes, and reduced PWI- @entity353 mismatch (P=0.038) were associated with END in the univariate analysis. Only hyperacute @entity353 volume remained as a predictor of END when a logistic regression model was applied (odds ratio, 11.5; 95% CI, 2.31 to 57.10; P=0.0028). A receiver operator characteristic curve identified a cutoff point of @entity353 >89 cm(3) (sensitivity, 85.7%; specificity, 95.7%) to predict END. A graded response was seen in @entity353 lesion expansion in relation to duration of @entity432 (P=0.017). CONCLUSIONS: Ultra-early @entity353 is a powerful predictor of END after MCA or @entity432 .
