First Automated Stroke Imaging Evaluation via Electronic Alberta Stroke Program Early CT Score in a Mobile Stroke Unit
First Automated Stroke Imaging Evaluation via Electronic Alberta Stroke Program Early CT Score in a Mobile Stroke Unit
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DOI：
10.1159/000446861
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发表时间：
2016-12-01
影响因子：
2.9
通讯作者：
Fassbender, Klaus
中科院分区：
文献类型：
--
作者：
Grunwald, Iris Quasar;Ragoschke-Schumm, Andreas;Fassbender, Klaus
背景：最近，一种移动的卒中单元（MSU）被证明可以直接在急诊现场进行急性卒中治疗。MSU的神经放射学专业知识通过使用新型软件程序（计算电子阿尔伯塔卒中计划早期CT评分（e-ASPECTS））对CT扫描进行自动电子（e）评价来检测早期缺血性损伤的能力得到提高。研究方法：将e-ASPECTS集成到救护车的可行性进行了研究，并在15个连续的情况下，该软件的临床集成和实用性进行了评估。结果：在MSU和院前卒中管理中实施e-ASPECTS是可行的。e-ASPECTS的值与MSU团队的传统神经放射学分析结果相匹配。三个案例说明了e-ASPECTS的潜在好处。在病例1中，排除早期梗死体征支持直接进行院前溶栓的决定。在病例2中，卒中由大血管闭塞引起，高e-ASPECTS值支持开始动脉内治疗并将患者分诊至综合卒中中心的决定。在病例3中，e-ASPECTS值为10，表明尽管预先存在脑微血管病和大血管病，但不存在早期梗死体征，这一发现表明程序对伪影的稳健性。结论：这项关于通过MSU将e-ASPECTS整合到院前卒中管理中的研究首次表明，这种整合是可行的，并有助于决定治疗方案和最合适的目标医院的分诊。(C)2016 S. Karger AG，巴塞尔
Background: Recently, a mobile stroke unit (MSU) was shown to facilitate acute stroke treatment directly at the emergency site. The neuroradiological expertise of the MSU is improved by its ability to detect early ischemic damage via automatic electronic (e) evaluation of CT scans using a novel software program that calculates the electronic Alberta Stroke Program Early CT Score (e-ASPECTS). Methods: The feasibility of integrating e-ASPECTS into an ambulance was examined, and the clinical integration and utility of the software in 15 consecutive cases evaluated. Results: Implementation of e-ASPECTS onto the MSU and into the prehospital stroke management was feasible. The values of e-ASPECTS matched with the results of conventional neuroradiologic analysis by the MSU team. The potential benefits of e-ASPECTS were illustrated by three cases. In case 1, excluding early infarct signs supported the decision to directly perform prehospital thrombolysis. In case 2, in which stroke was caused by large-vessel occlusion, the high e-ASPECTS value supported the decision to initiate intra-arterial treatment and triage the patient to a comprehensive stroke center. In case 3, the e-ASPECTS value was 10, indicating the absence of early infarct signs despite pre-existing cerebral microangiopathy and macroangiopathy, a finding indicating the program's robustness against artefacts. Conclusions: This study on the integration of e-ASPECTS into the prehospital stroke management via a MSU showed for the first time that such integration is feasible, and aids both decision regarding the treatment option and the triage regarding the most appropriate target hospital. (C) 2016 S. Karger AG, Basel