Diffusion-weighted imaging determinants for acute ischemic stroke diagnosis in the emergency room

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dc.contributor.authorBrunser, Alejandro M.
dc.contributor.authorCavada, Gabriel
dc.contributor.authorMuñoz Venturelli, Paula
dc.contributor.authorOlavarría, Verónica
dc.contributor.authorRojo, Alexis
dc.contributor.authorAlmeida, Juan
dc.contributor.authorDíaz, Violeta
dc.contributor.authorHoppe, Arnold
dc.contributor.authorLavados, Pablo
dc.date.accessioned2022-05-24T16:49:07Z
dc.date.available2022-05-24T16:49:07Z
dc.date.issued2018
dc.description.abstractPurpose The aim of this study was to investigate the clinical-radiological determinants of diffusion-weighted image (DWI) abnormalities in patients with suspected acute ischemic stroke (AIS) seen at the emergency room (ER). Methods During the study period, 882 consecutive patients were screened at Clínica Alemana de Santiago, Chile; 786 had AIS and 711 (90.4%) were included. Results DWI demonstrated 87.3% sensitivity and 99.0% specificity, with a positive likelihood ratio of 79 and a negative likelihood ratio of 0.13 for the detection of AIS. In the univariate analysis, a positive DWI in AIS was associated with admission National Institute of Health Stroke Scale (NIHSS) score (OR 1.09, 95% CI 1.04–1.1%), time from symptom onset to DWI (OR 1.03, 95% CI 1.01–1.05), presence of a relevant intracranial artery occlusion (OR 3.18, 95% CI 1.75–5.76), posterior circulation ischemia (OR 0.44, 95% CI 0.28–0.7), brainstem location of the AIS (OR 0.16, 95% CI 0.093–0.27), infratentorial location of AIS (OR 0.44, 95% CI 0.28–0.70), and lacunar (OR 0.27, 95% CI 0.11–0.68) or undetermined stroke etiology (OR 0.12, 95% CI 0.3–0.31). In multivariate analysis, only admission NIHSS score (OR 1.07, 95% CI 1.01–1.13), time from symptom onset to DWI (OR 1.04, 95% CI 1.01–1.13), brainstem location (OR 0.13, 95% CI 0.051–0.37), and lacunar (OR: 0.4, 95% CI 0.21–0.78) or undetermined etiology (OR: 0.4, 95% CI 0.22–0.78) remained independently associated. Conclusion DWI detects AIS accurately; the positivity of these evaluations in the ER is associated only with NIHSS on admission, time to DWI, brainstem location, and AIS etiology.es
dc.description.versionVersión Publicadaes
dc.identifier.citationBrunser AM, Cavada G, Venturelli PM, Olavarría V, Rojo A, Almeida J, Díaz V, Hoppe A, Lavados P. Diffusion-weighted imaging determinants for acute ischemic stroke diagnosis in the emergency room. Neuroradiology. 2018 Jul;60(7):687-692. doi: 10.1007/s00234-018-2029-x. Epub 2018 May 22. PMID: 29789895.es
dc.identifier.urihttps://doi.org/10.1007/s00234-018-2029-xes
dc.identifier.urihttp://hdl.handle.net/11447/6131
dc.language.isoenes
dc.subjectDiffusion-weighted imaginges
dc.subjectIschemic strokees
dc.subjectDiagnosises
dc.titleDiffusion-weighted imaging determinants for acute ischemic stroke diagnosis in the emergency roomes
dc.typeArticlees
dcterms.sourceNeuroradiologyes

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