Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy
Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy
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DOI：
10.1016/s0140-6736(00)02237-6
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发表时间：
2000-05-13
期刊：
影响因子：
168.9
通讯作者：
Buchan, AM
中科院分区：
文献类型：
--
作者：
Barber, PA;Demchuk, AM;Buchan, AM
背景：超急性期缺血性脑卒中溶栓治疗前必须进行CT检查，但CT早期缺血性改变的意义尚不清楚。我们测试了定量CT评分，阿尔伯塔中风项目早期CT评分（ASPECTS）。方法203例缺血性中风患者在两个北美教学医院症状发作3小时内静脉注射阿替普酶治疗。对所有治疗前CT扫描进行前瞻性评分。该分数将大脑中动脉区域划分为十个感兴趣区域。主要结局为症状性脑出血和3个月功能结局。计算ASPECTS对主要结局的敏感性和特异性。Logistic回归分析被用来测试ASPECTS和主要outcomes.Findings缺血性变化的基线CT评分之间的关联被认为是在117（75%）的156例治疗前循环缺血的患者包括在分析（23缺血后循环和24外的协议）。基线ASPECTS值与美国国立卫生研究院卒中量表上的卒中严重程度呈负相关（r=-0.56，p
Background Computed tomography (CT) must be done before thrombolytic treatment of hyperacute ischaemic stroke, but the significance of early ischaemic change on CT is unclear. We tested a quantitative CT score, the Alberta Stroke Programme Early CT Score (ASPECTS).Methods 203 consecutive patients with ischaemic stroke were treated with intravenous alteplase within 3 h of symptom onset in two North American teaching hospitals. All pretreatment CT scans were prospectively scored. The score divides the middle-cererbral-artery territory into ten regions of interest. Primary outcomes were symptomatic intracerebral haemorrhage and 3-month functional outcome. The sensitivity and specificity of ASPECTS for the primary outcomes were calculated. Logistic regression was used to test the association between the score on ASPECTS and the primary outcomes.Findings Ischaemic changes on the baseline CT were seen in 117 (75%) of 156 treated patients with anterior-circulation ischaemia included in the analysis (23 had ischaemia in the posterior circulation and 24 were treated outside the protocol). Baseline ASPECTS value correlated inversely with the severity of stroke on the National institutes of Health Stroke Scale (r=-0.56, p