Accuracy of the Alberta Stroke Program Early CT Score during the First 3 Hours of Middle Cerebral Artery Stroke: Comparison of Noncontrast CT, CT Angiography Source Images, and CT Perfusion
Open Access
- 13 February 2008
- journal article
- research article
- Published by American Society of Neuroradiology (ASNR) in American Journal of Neuroradiology
- Vol. 29 (5), 931-936
- https://doi.org/10.3174/ajnr.a0975
Abstract
BACKGROUND AND PURPOSE: The Alberta Stroke Program Early CT Score (ASPECTS) is a reliable method of delineating the extent of middle cerebral artery (MCA) stroke. Our aim was to retrospectively compare the accuracy of ASPECTS on noncontrast CT, CT angiography (CTA) source images, and CT perfusion maps of cerebral blood volume (CBV) during the first 3 hours of middle cerebral artery (MCA) stroke. MATERIALS AND METHODS: First-time patients with MCA stroke who presented P values <.05 were considered significant. RESULTS: Twenty-eight patients satisfied the criteria with DWI performed at a mean of 50.3 hours (range, 22–125 hours) post-CT imaging. Of 280 ASPECTS regions, 100 were infarcted on DWI. The accuracy of noncontrast CT, CTA source images, and CT perfusion CBV for detecting regional infarct was 80.0%, 84.3%, and 96.8%, respectively (P < .0001). The mean ASPECTSs of noncontrast CT, CTA source images, CT perfusion CBV, and DWI were 8.4 ± 1.8, 8.0 ± 1.8, 6.8 ± 1.9, and 6.5 ± 1.8, respectively. The mean noncontrast CT and CTA source image ASPECTS was different from that of DWI (P < .05). Correlation of noncontrast CT, CTA source images, and CT perfusion CBV ASPECTS with final ASPECTS was r2 = 0.34, r2 = 0.42, and r2 = 0.91, respectively. CONCLUSION: In a retrospective cohort of MCA infarcts imaged <3 hours from stroke onset, ASPECTS was most accurately determined on CT perfusion CBV maps.Keywords
This publication has 20 references indexed in Scilit:
- Alberta Stroke Program Early CT Scoring of CT Perfusion in Early Stroke Visualization and AssessmentAmerican Journal of Neuroradiology, 2007
- Acute Brain Infarct: Detection and Delineation with CT Angiographic Source Images versus Nonenhanced CT ScansRadiology, 2007
- Early stroke detection and extent: impact of experience and the role of computed tomography angiography source imagesClinical Radiology, 2007
- Extent of Early Ischemic Changes on Computed Tomography (CT) Before ThrombolysisStroke, 2006
- Perfusion computed tomography: Prediction of final infarct extent and stroke outcomeAnnals of Neurology, 2005
- Importance of Early Ischemic Computed Tomography Changes Using ASPECTS in NINDS rtPA Stroke StudyStroke, 2005
- Thrombolysis for acute ischemic stroke: results of the Canadian Alteplase for Stroke Effectiveness StudyCMAJ : Canadian Medical Association Journal, 2005
- ASPECTS on CTA Source Images Versus Unenhanced CTStroke, 2004
- Selection of Acute Ischemic Stroke Patients for Intra-Arterial Thrombolysis With Pro-Urokinase by Using ASPECTSStroke, 2003
- Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapyThe Lancet, 2000