Ferreti Lucas Andrade, Leitao Cleverson Alex, Teixeira Bernardo Corrêa de Almeida, Lopes Neto Francisco Diego Negrao, ZÉtola Viviane Flumignan, Lange Marcos Christiano
Universidade Federal do Paraná, Curitiba PR, Brazil.
Arq Neuropsiquiatr. 2020 Dec;78(12):757-761. doi: 10.1590/0004-282X20200072.
The rapid evaluation of non-contrast-enhanced computed tomography (NCCT) brain scans in patients with anterior stroke symptoms saves time and favors optimal and prompt treatment. e-ASPECTS is a tool that automatically calculates the Alberta Stroke Program Early CT Score (ASPECTS) values, leading to a more accurate and timely image evaluation.
To determine the ability of e-ASPECTS in differentiating images with and without injury.
One-hundred sixteen patients admitted to a stroke unit in a Brazilian tertiary hospital underwent a CT scan at admission and at least one control brain imaging (NCCT or magnetic resonance imaging - MRI) 24 hours after admission. ASPECTS evaluation was performed by three neuroradiologists, three neurologists, and three neurology residents, all blinded to the symptoms and the injury side. The scores were compared to the ground truth, and an ASPECTS score was provided by two independent non blinded evaluators. Sensitivity and specificity were analyzed, and receiver operating characteristic curves, Bland-Altman plots with mean error score, and Matthews correlation coefficients (MCCs) were obtained for ASPECTS scores, assuming values equal to 10 for images without injury and values other than 10 for images with ischemic injury.
e-ASPECTS demonstrated similar performance to that of neuroradiologists and neurologists, with an area under the curve of 0.78 and an MCC value of 0.48 in the dichotomous analysis. The sensitivity and specificity of e-ASPECTS were 75% and 73%, respectively.
e-ASPECTS is a validated and reliable tool for determining early signs of ischemia in NCCT.
对有前循环卒中症状的患者进行非增强计算机断层扫描（NCCT）脑扫描的快速评估可节省时间，并有助于进行最佳和及时的治疗。电子阿尔伯塔卒中早期CT评分（e-ASPECTS）是一种可自动计算阿尔伯塔卒中项目早期CT评分（ASPECTS）值的工具，能实现更准确、及时的图像评估。
确定e-ASPECTS区分有无损伤图像的能力。
巴西一家三级医院卒中单元收治的116例患者在入院时接受了CT扫描，并在入院24小时后至少接受了一次对照脑成像检查（NCCT或磁共振成像-MRI）。由三名神经放射科医生、三名神经科医生和三名神经内科住院医师进行ASPECTS评估，他们均对症状和损伤侧不知情。将评分与真实情况进行比较，并由两名独立的非盲评估者提供ASPECTS评分。分析敏感性和特异性，并针对ASPECTS评分获得受试者操作特征曲线、带有平均误差评分的布兰德-奥特曼图以及马修斯相关系数（MCC），假设无损伤图像的值等于10，有缺血性损伤图像的值不等于10。
在二分法分析中，e-ASPECTS表现出与神经放射科医生和神经科医生相似的性能，曲线下面积为0.78，MCC值为0.48。e-ASPECTS的敏感性和特异性分别为75%和73%。
e-ASPECTS是一种经过验证的、可靠的用于确定NCCT中缺血早期征象的工具。
