PMID- 15377690
OWN - NLM
STAT- MEDLINE
DCOM- 20041019
LR  - 20181113
IS  - 0022-3050 (Print)
IS  - 1468-330X (Electronic)
IS  - 0022-3050 (Linking)
VI  - 75
IP  - 10
DP  - 2004 Oct
TI  - The probability of middle cerebral artery MRA flow signal abnormality with 
      quantified CT ischaemic change: targets for future therapeutic studies.
PG  - 1426-30
AB  - OBJECTIVES: In this study we define the probability of vascular abnormality in 
      the middle cerebral artery (MCA) territory according to the extent of ischaemic 
      change seen using computed tomography (CT). We assessed the sensitivity and 
      specificity of the hyperdense middle cerebral artery (HMCA) and the "dot" sign 
      using magnetic resonance angiography (MRA). METHODS: Patients presenting with 
      ischaemic stroke had a CT scan (<6 h) prior to MRI (<7 h). A quantitative CT 
      scoring system (ASPECTS) was applied to CT and diffusion weighted images (DWI) at 
      baseline and follow up (24 h) by five independent observers. The presence of HMCA 
      and the MCA "dot" sign was also evaluated. An expert reader assessed the 3D time 
      of flight (TOF) MRA in the anterior circulation for areas of decreased vascular 
      signal in the MCA territory, with an absent signal taken to represent severely 
      reduced or absent flow. RESULTS: A total of 100 consecutive patients had baseline 
      CT and MR scans. The median NIHSS was 9. The median CT ASPECTS was 8 and equalled 
      the median DWI ASPECTS. There were a total of 10 HMCA and 19 MCA "dot" signs, 
      with four patients having both HMCA and "dot" signs. A total of 47 MRA flow 
      signal abnormalities were observed in the anterior circulation. CONCLUSIONS: In 
      the absence of accessible neurovascular imaging, the extent of CT ischaemia 
      (ASPECTS) is a strong predictor of vascular occlusion. The CT hyperdense artery 
      signs have a high positive predictive value but low negative predictive value.
FAU - Barber, P A
AU  - Barber PA
AD  - Department of Clinical Neurosciences, Calgary Stroke Program, Seaman Family 
      Magnetic Research Centre, NW, Calgary, Canada AB T2N 4N1. pabarber@ucalgary.ca
FAU - Demchuk, A M
AU  - Demchuk AM
FAU - Hill, M D
AU  - Hill MD
FAU - Pexman, J H Warwick
AU  - Pexman JH
FAU - Hudon, M E
AU  - Hudon ME
FAU - Frayne, R
AU  - Frayne R
FAU - Buchan, A M
AU  - Buchan AM
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - J Neurol Neurosurg Psychiatry
JT  - Journal of neurology, neurosurgery, and psychiatry
JID - 2985191R
SB  - IM
EIN - J Neurol Neurosurg Psychiatry. 2005 Mar;76(3):458
MH  - Aged
MH  - Aged, 80 and over
MH  - Brain Ischemia/*diagnostic imaging/etiology/*pathology
MH  - Diffusion Magnetic Resonance Imaging
MH  - Female
MH  - Humans
MH  - Image Processing, Computer-Assisted
MH  - Infarction, Middle Cerebral Artery/*diagnostic imaging/*pathology
MH  - *Magnetic Resonance Angiography
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Sensitivity and Specificity
MH  - *Tomography, X-Ray Computed
PMC - PMC1738728
EDAT- 2004/09/21 05:00
MHDA- 2004/10/20 09:00
PMCR- 2007/10/01
CRDT- 2004/09/21 05:00
PHST- 2004/09/21 05:00 [pubmed]
PHST- 2004/10/20 09:00 [medline]
PHST- 2004/09/21 05:00 [entrez]
PHST- 2007/10/01 00:00 [pmc-release]
AID - 75/10/1426 [pii]
AID - 10.1136/jnnp.2003.029389 [doi]
PST - ppublish
SO  - J Neurol Neurosurg Psychiatry. 2004 Oct;75(10):1426-30. doi: 
      10.1136/jnnp.2003.029389.