Evaluation of hyperacute infarct volume using ASPECTS and brain CT perfusion core volume

Neurology
Jelle DemeestereChristopher Levi

Abstract

To compare the accuracy of Alberta Stroke Program Early Computed Tomography Score (ASPECTS) and CT perfusion to detect established infarction in acute anterior circulation stroke. We performed an observational study in 59 acute anterior circulation ischemic stroke patients who underwent brain noncontrast CT, CT perfusion, and MRI within 100 minutes from CT imaging. ASPECTS scores were calculated by 4 blinded vascular neurologists. The accuracy of ASPECTS and CT perfusion core volume to detect an acute MRI diffusion lesion of ≥70 mL was evaluated using receiver operating characteristics analysis and optimum cutoff values were calculated using Youden J. Median ASPECTS score was 8 (interquartile range [IQR] 5-9). Median CT perfusion core volume was 22 mL (IQR 10.4-71.9). Median MRI diffusion lesion volume was 24.5 mL (IQR 10-63.9). No significant difference was found between the accuracy of CT perfusion and ASPECTS (c statistic 0.95 vs 0.87, p value for difference = 0.17). The optimum ASPECTS cutoff score to detect a diffusion-weighted imaging lesion ≥70 mL was <7 (sensitivity 0.74, specificity 0.86, Youden J = 0.60) and the optimum CT perfusion core volume cutoff was ≥50 mL (sensitivity 0.86, specificity 0.97, Youden J = 0.84). T...Continue Reading

References

Jul 5, 2003·Stroke; a Journal of Cerebral Circulation·Michael D HillUNKNOWN PROACT-II Investigators
Oct 22, 2005·Annals of Neurology·Mark W ParsonsChristopher R Levi
Aug 19, 2008·International Journal of Stroke : Official Journal of the International Stroke Society·Mark W Parsons
Nov 15, 2011·Brain : a Journal of Neurology·Andrew BivardMark Parsons
Sep 8, 2012·Lancet Neurology·Maarten G LansbergUNKNOWN DEFUSE 2 study investigators
Jun 14, 2013·Stroke; a Journal of Cerebral Circulation·Jean-Marc OlivotMikael Mazighi
Dec 18, 2014·The New England Journal of Medicine·Olvert A BerkhemerUNKNOWN MR CLEAN Investigators
Feb 12, 2015·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA Investigators
Feb 12, 2015·The New England Journal of Medicine·Mayank GoyalUNKNOWN ESCAPE Trial Investigators
Apr 18, 2015·The New England Journal of Medicine·Jeffrey L SaverUNKNOWN SWIFT PRIME Investigators
Apr 18, 2015·The New England Journal of Medicine·Tudor G JovinUNKNOWN REVASCAT Trial Investigators

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Citations

Mar 16, 2018·International Journal of Stroke : Official Journal of the International Stroke Society·Carlos Garcia-EsperonMark Parsons
Nov 10, 2017·Current Opinion in Neurology·Andrew Bivard, Mark Parsons
May 20, 2018·Stroke; a Journal of Cerebral Circulation·Simon NagelUNKNOWN ENCHANTED Investigators
Jul 23, 2019·Stroke; a Journal of Cerebral Circulation·Gustavo SaposnikMayank Goyal
Aug 21, 2019·Stroke; a Journal of Cerebral Circulation·David S LiebeskindEdward C Jauch
May 18, 2019·Journal of Neurointerventional Surgery·Sarah LeeRobert L Dodd
Aug 30, 2019·Stroke; a Journal of Cerebral Circulation·Shalini AmukotuwaRoland Bammer
Nov 26, 2019·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·James E SieglerEva A Mistry
Apr 7, 2020·Stroke; a Journal of Cerebral Circulation·Hidehisa NishiSusumu Miyamoto
Jan 14, 2020·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Marie-Claude BeaulieuCéline Odier
Dec 12, 2018·Journal of Neurointerventional Surgery·Syed Ali RazaSrikant Rangaraju
Jun 28, 2020·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Thomas SnyderShadi Yaghi
Jun 21, 2018·Journal of Neurology·XuYing Xiang, Fei Cao
Nov 25, 2018·Clinical Neuroradiology·Anderson Chun On TsangJoanna D Schaafsma
Oct 26, 2018·Stroke; a Journal of Cerebral Circulation·Yu SakaiKambiz Nael
Dec 29, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Yu-Ming ChangVladimir Ivanovic
Feb 1, 2021·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Keigo ShigetaUNKNOWN TREAT study group
Mar 25, 2021·Circulation. Cardiovascular Quality and Outcomes·Ashby C Turner, Kori S Zachrison
May 16, 2021·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Qianmei JiangGuodong Xiao
Sep 21, 2021·Stroke; a Journal of Cerebral Circulation·Gabriel BroocksUta Hanning

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Methods Mentioned

BETA
imaging techniques

Software Mentioned

SPSS
MIStar
ASPECTS

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