Parsons Mark W, Pepper Elizabeth M, Chan Virgil, Siddique Sabbir, Rajaratnam Siva, Bateman Grant A, Levi Christopher R
Department of Neurology, John Hunter Hospital, and Hunter Medical Research Institute, University of Newcastle, New South Wales, Australia.
Ann Neurol. 2005 Nov;58(5):672-9. doi: 10.1002/ana.20638.
The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) has not been previously applied to perfusion CT (CTP). Five raters assigned ASPECTS to baseline noncontrast CT (NCCT), CT angiography source images (CTA-SI), CTP source images (CTP-SI), and CTP maps of cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) from 37 consecutive patients with less than 6-hour anterior circulation ischemic stroke. Major reperfusion was identified on follow-up imaging. Mean baseline ASPECTS was compared with follow-up imaging ASPECTS. Rates of favorable outcome were compared for dichotomized baseline ASPECTS. In patients with major reperfusion, mean CBV and CTP-SI ASPECTS closely predicted final infarct ASPECTS. In patients without major reperfusion, mean CBF and MTT ASPECTS best predicted final infarct ASPECTS. There were significant increases in rates of favorable outcome for CTP-SI and CBV ASPECTS of greater than 6, versus less than or equal to 6, but not for other baseline CT modalities. ASPECTS applied to CTP is more accurate at identifying the extent of reversible and irreversible ischemia and at predicting final clinical outcome than NCCTor CTA-SI.
艾伯塔卒中项目早期计算机断层扫描评分（ASPECTS）此前尚未应用于灌注CT（CTP）。五名评估者对37例连续的发病时间少于6小时的前循环缺血性卒中患者的基线非增强CT（NCCT）、CT血管造影源图像（CTA-SI）、CTP源图像（CTP-SI）以及脑血容量（CBV）、脑血流量（CBF）和平均通过时间（MTT）的CTP图进行ASPECTS评分。在随访成像中确定主要再灌注情况。将平均基线ASPECTS与随访成像的ASPECTS进行比较。对二分法的基线ASPECTS比较良好结局的发生率。在主要再灌注的患者中，平均CBV和CTP-SI的ASPECTS能密切预测最终梗死灶的ASPECTS。在无主要再灌注的患者中，平均CBF和MTT的ASPECTS能最佳预测最终梗死灶的ASPECTS。CTP-SI和CBV的ASPECTS大于6分与小于或等于6分相比，良好结局发生率有显著增加，但其他基线CT检查方式则不然。与NCCT或CTA-SI相比，应用于CTP的ASPECTS在识别可逆性和不可逆性缺血范围以及预测最终临床结局方面更准确。
