Puetz V, Dzialowski I, Hill M D, Demchuk A M
Department of Neurology, Dresden University Stroke Centre, University of Technology Dresden, Dresden, Germany.
Int J Stroke. 2009 Oct;4(5):354-64. doi: 10.1111/j.1747-4949.2009.00337.x.
The introduction of brain imaging with computed tomography revolutionised the treatment of patients with acute ischaemic stroke. With the visual differentiation of haemorrhagic stroke from ischaemic stroke, thrombolytic therapy became feasible. The Alberta Stroke Program Early CT Score was devised to quantify the extent of early ischaemic changes in the middle cerebral artery territory on noncontrast computed tomography. With its systematic approach, the score is simple and reliable. However, the assessment of early ischaemic changes and Alberta Stroke Program Early CT scoring require training. The Alberta Stroke Program Early CT Score is a strong predictor of functional outcome. Furthermore, the effectiveness of intraarterial thrombolysis in patients with middle cerebral artery occlusion shows effect modification by the Alberta Stroke Program Early CT Score. This review summarises the Alberta Stroke Program Early CT Score methodology. We illustrate current knowledge regarding Alberta Stroke Program Early CT Score applied to clinical trials and comment on how Alberta Stroke Program Early CT Score may facilitate clinical treatment decision making and future trial design. Moreover, we introduce a modification of the Alberta Stroke Program Early CT Score methodology that disregards isolated cortical swelling, i.e. focal brain swelling without associated parenchymal hypoattenuation, as early ischaemic changes in the Alberta Stroke Program Early CT Score system.
计算机断层扫描脑成像技术的引入彻底改变了急性缺血性中风患者的治疗方式。随着出血性中风与缺血性中风在视觉上的区分，溶栓治疗变得可行。阿尔伯塔中风项目早期CT评分旨在量化非增强计算机断层扫描上大脑中动脉区域早期缺血性改变的程度。该评分采用系统方法，简单且可靠。然而，早期缺血性改变的评估以及阿尔伯塔中风项目早期CT评分需要培训。阿尔伯塔中风项目早期CT评分是功能预后的有力预测指标。此外，大脑中动脉闭塞患者动脉内溶栓的有效性显示出受阿尔伯塔中风项目早期CT评分的影响。本综述总结了阿尔伯塔中风项目早期CT评分方法。我们阐述了有关阿尔伯塔中风项目早期CT评分应用于临床试验的当前知识，并对阿尔伯塔中风项目早期CT评分如何促进临床治疗决策和未来试验设计发表评论。此外，我们介绍了一种对阿尔伯塔中风项目早期CT评分方法的修改，即在阿尔伯塔中风项目早期CT评分系统中，将孤立的皮质肿胀（即无相关实质低密度的局灶性脑肿胀）排除在早期缺血性改变之外。
