DWI-ASPECTS And MRA-CBS Predict Hemorrhagic Transformation After Thrombolysis In Acute Cerebral Infarction

Purpose:To assess the value of DWI-ASPECTS and MRA-CBS in predicting hemorrhagic transformation in acute anterior circulation cerebral infarction after thrombolysis.Methods:Thirty-seven consecutive patients with acute anterior circulation cerebral infarction were enrolled. The clinical information before thrombolysis and MRI features before and after thrombolysis were retrospectively assessed. According to the ESWAN scanned within24hours after thrombolysis, we divided patients into two groups:with HT and without HT. Then we compared clinical characteristics, scores of DWI-ASPECTS, scores of MRA-CBS and lesion volume on DWI of the two groups at admission. Further, the value of different factors above in predicting HT independently after thrombolysis was evaluated. Results:Patients with HT had higher baseline NIHSS scores (mean,15vs.7, p=0.00020), a lower DWI-ASPECTS (median,6vs.9, p=0.00004), a lower MRA-CBS(median,7vs.10, p=0.04587) and a larger lesion on DWI (median,14vs.0, p=0.00037) than those without HT. DWI-ASPECTS (OR OR0.424,95%CI0.206-0.872, p=0.020) and NIHSS scores (OR1.219,95%CI1.003-1.481, p=0.046) at baseline predicted HT development independently. The optimal cut-off point of DWI-ASPECTS to predict development of HT within24hours after thrombolysis was<=7(sensitivity92.9%, specificity78.3%,an area under the ROC0.902,p=0.00005)Conclusion:ASPECTS on DWI is of great value in predicting HT after thrombolysis in acute anterior cerebral infarction. CBS on MRA can provide additional information for predicting HT.