Mokin Maxim, Primiani Christopher T, Siddiqui Adnan H, Turk Aquilla S
From the Department of Neurosurgery, University of South Florida, Tampa (M.M., C.T.P.); Department of Neurosurgery, University at Buffalo, NY (A.H.S.); and Department of Neurosurgery, Medical University of South Carolina, Charleston (A.S.T.).
Stroke. 2017 Jun;48(6):1574-1579. doi: 10.1161/STROKEAHA.117.016745. Epub 2017 May 9.
The ASPECTS (Alberta Stroke Program Early CT Score) is a quantitate score that measures the extent of early ischemic changes. Our aim was to investigate how measurement of ASPECTS using Hounsfield unit (HU) values on initial noncontrast head computerized tomography (CT) correlates with the extent of final infarct on follow-up imaging.
Cases of acute stroke from the middle cerebral artery M1 occlusion in which complete recanalization (TICI [Thrombolysis in Cerebral Infarction] 3) was achieved were included for analysis. Using HU ratio (HU affected/HU control hemisphere) and HU difference (HU control-HU affected hemisphere) values, ASPECTS was measured on initial CT imaging and correlated with final ASPECTS at 24 hours. The study cohort consisted of 41 patients with acute stroke from the M1 occlusion. The mean time from stroke symptoms onset to baseline head CT imaging was 264 minutes and from CT to TICI 3 recanalization was 142 minutes.
HU ratio within the 0.94 to 0.96 ranges showed the highest correlation coefficient and lowest mean and median errors with the final ASPECTS. The difference of 2.0 HU between the 2 hemispheres demonstrated the higher correlation coefficient (=0.71; <0.0001) and the lowest mean and median absolute errors (1.4 and 1, respectively).
We established a simple algorithm for rapid and accurate assessment of ASPECTS on baseline CT imaging to predict the extent of final stroke in patients with emergent large vessel occlusion who undergo endovascular revascularization.
ASPECTS（阿尔伯塔卒中项目早期CT评分）是一种定量评分，用于测量早期缺血性改变的程度。我们的目的是研究在初始非增强头部计算机断层扫描（CT）上使用亨氏单位（HU）值测量ASPECTS与随访成像时最终梗死范围之间的相关性。
纳入大脑中动脉M1段闭塞且实现完全再通（脑梗死溶栓[TICI]3级）的急性卒中病例进行分析。利用HU比值（患侧HU/对照侧半球HU）和HU差值（对照侧HU - 患侧半球HU）值，在初始CT成像上测量ASPECTS，并与24小时时的最终ASPECTS进行相关性分析。研究队列包括41例M1段闭塞的急性卒中患者。从卒中症状发作到基线头部CT成像的平均时间为264分钟，从CT到TICI 3级再通的平均时间为142分钟。
HU比值在0.94至0.96范围内与最终ASPECTS的相关系数最高，平均误差和中位数误差最低。两半球之间2.0 HU的差值显示出更高的相关系数（=0.71；<0.0001）以及最低的平均绝对误差和中位数绝对误差（分别为1.4和1）。
我们建立了一种简单算法，用于在基线CT成像上快速准确地评估ASPECTS，以预测接受血管内血运重建的急性大血管闭塞患者的最终卒中范围。
