Alberta Stroke Program Early CT Score Versus Computed Tomographic Perfusion to Predict Functional Outcome After Successful Reperfusion in Acute Ischemic Stroke.
Alberta Stroke Program Early CT Score Versus Computed Tomographic Perfusion to Predict Functional Outcome After Successful Reperfusion in Acute Ischemic Stroke.
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DOI：
10.1161/strokeaha.118.021961
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发表时间：
2018-10
期刊：
影响因子：
8.3
通讯作者：
Lemmens R
中科院分区：
文献类型：
--
作者：
Demeestere J;Scheldeman L;Cornelissen SA;Heye S;Wouters A;Dupont P;Christensen S;Mlynash M;Albers GW;Lansberg M;Lemmens R
We aimed to compare the ability of conventional Alberta Stroke Program Early Computed Tomography Score (ASPECTS), automated ASPECTS and ischemic core volume on CT perfusion (CTP) to predict clinical outcome in ischemic stroke due to large vessel occlusion up to 18 hours after symptom onset. We selected acute ischemic stroke patients from the Computed Tomography Perfusion to Predict Response to Recanalization in ischemic Stroke Project (CRISP) study with successful reperfusion (modified treatment in cerebral ischemia score 2b or 3). We used e-ASPECTS software to calculate automated ASPECTS and RAPID software to estimate ischemic core volumes. We studied associations between these imaging characteristics and good outcome (modified Rankin Scale [mRS] 0–2) or poor outcome (mRS 4–6) in univariable and multivariable analysis, after adjustment for relevant clinical confounders. We included 156 patients. Conventional and automated ASPECTS were not associated with good or poor outcome in univariable analysis (p = NS for all). Automated ASPECTS was associated with good outcome in multivariable analysis (p = 0.02), but not with poor outcome. Ischemic core volume was associated with good (p < 0.01) and poor outcome (p = 0.04) in univariable and multivariable analysis (p = 0.03 and p = 0.02 respectively). CTP predicted good outcome with an area under the curve (AUC) of 0.62 (95% CI 0.53–0.71) and optimal cut-off core volume of 15 ml. Ischemic core volume assessed on CTP is a predictor of clinical outcome among patients in whom endovascular reperfusion is achieved up to 18 hours after symptom onset. In this population, conventional or automated ASPECTS did not predict outcome.
