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- W2587235584 abstract "Objective: To test the hypothesis that ADC reversal, and not 24 hour ADC volume, will identify AIS patients treated with tissue plasminogen activator (tPA) who have early reperfusion (ERP). Background: Change in ADC after AIS is a dynamic process that evolves over time. Early reperfusion is associated with good outcome, but its relationship to early and late changes in ADC volume remains unclear. Methods: AIS patients enrolled in NINDS natural history study 2013-2014 with MRI scans pre-, 2 hours post-, and 24 hours post-IV tPA were included. Regions of interest (ROI) were defined on the first MRI as time-to-peak lesion >4 seconds. ERP was defined as >80[percnt] reperfusion at 2 hours. ADC volume was defined within each ROI using a threshold of 600. ADC reversal was defined as a decrease in ADC volume between the pre- and 2 hour-MRI. Hemorrhagic transformation and NIHSS were assessed. Results: Of the 31 patients included, 55[percnt] had early ADC reversal at 2 hours (13[percnt] sustained at 24 hours), and 45[percnt] had ERP at 2 hours. ADC reversal was associated with ERP at 2 hours (OR 14.4 [95[percnt] CI, 2.3-89.3], p=0.004). ADC volume at 24 hours was similar between patients with and without reversal (17.5mL vs 15.3mL) and did not correlate with ERP (p=0.21) or early reversal (p=0.57). ADC reversal was associated with reductions in NIHSS from baseline to 24 hours (-6 vs -3 points, p=0.03), and lower rates of hemorrhagic transformation (64[percnt] vs 24[percnt], p=0.05), than in patients without reversal. Conclusions: In our population, early ADC reversal, even when not sustained at 24 hours, was a marker for ERP, larger reductions in NIHSS from baseline, and less hemorrhagic transformation. Thus early fluctuations in ADC volume may be a more predictive radiographic marker for response to thrombolysis, and possibly clinical outcome, than 24-hour ADC volume. Disclosure: Dr. Simpkins has nothing to disclose. Dr. Benson has nothing to disclose. Dr. Hsia has nothing to disclose. Dr. Luby has nothing to disclose. Dr. Lynch has nothing to disclose. Dr. Nadareishvili has nothing to disclose. Dr. Latour has nothing to disclose. Dr. Leigh has nothing to disclose." @default.
- W2587235584 created "2017-02-17" @default.
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- W2587235584 date "2016-04-05" @default.
- W2587235584 modified "2023-09-23" @default.
- W2587235584 title "Apparent Diffusion Coefficient (ADC) Reversal as a Marker of Early Reperfusion in Acute Ischemic Stroke (AIS) Patients Treated with tPA (P2.298)" @default.
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