title: Comparison of CT and DWI findings in ischemic stroke patients within 3 hours of onset.
abstract: This study compared the detection rate of ischemic lesions within 3 hours of onset by computed tomography (CT) and diffusion-weighted magnetic resonance imaging (DWI). The study group comprised 130 patients (71 men; median age, 75 years) with an anterior territory stroke who underwent CT and DWI within 3 hours of onset. The lesions revealed on CT and DWI were assessed using the CT-Alberta Stroke Program Early CT Score (ASPECTS) and DWI-ASPECTS, and detection rates were compared for each ASPECTS region. The detection rate of ischemic lesions was higher on DWI than on CT (76.9% v 30.0%; P < .001). The DWI-ASPECTS score was not correlated with the CT-ASPECTS score (r = 0.51; P < .001). Ischemic lesions were detected in the insula (59.2% for DWI vs 15.4% for CT; P < .001), lentiform nucleus (43.8% v 20.0%; P < .001), and the M1 (30.8% v 6.9%, P < .001), M2 (50.8% v 6.2%; P = .006), M3 (28.5% v 3.1%; P = .006), M4 (32.3% v 6.9%; P < .001), M5 (48.5% v 10.8%; P < .001), and M6 (31.5% v 4.6%, P = .012) areas of the middle cerebral artery. DWI detected ischemic lesions significantly more frequently than CT in all ASPECTS regions except the caudate head and internal capsule.
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan. Electronic address: mitomin2005@yahoo.co.jp.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Mitomi
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Aoki
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Iguchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D002421:Caudate Nucleus / Q000473:pathology; D002533:Cerebral Angiography; D038524:Diffusion Magnetic Resonance Imaging; D018450:Disease Progression; D005260:Female; D006801:Humans; D020772:Internal Capsule / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult