Accuracy and reliability of PBV ASPECTS, CBV ASPECTS and NCCT ASPECTS in acute ischaemic stroke: a matched-pair analysis
Autor: | Fatih Seker, Sibu Mundiyanapurath, Martin Bendszus, Arne Potreck, Sabine Heiland, Johannes Ar Pfaff, Charlotte S. Weyland, Alina Falbesaner |
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Rok vydání: | 2021 |
Předmět: |
Matched-Pair Analysis
Blood volume perfusion Alberta Brain Ischemia 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale medicine.artery Multidetector Computed Tomography medicine Humans Computed Tomography Perfusion Imaging Radiology Nuclear Medicine and imaging dyna-CT Stroke FD-CT Ischemic Stroke Retrospective Studies medicine.diagnostic_test Cerebral infarction business.industry Reproducibility of Results Magnetic resonance imaging Original Articles General Medicine medicine.disease Cerebral Angiography Cerebrovascular Circulation Middle cerebral artery Neurology (clinical) business Nuclear medicine Perfusion 030217 neurology & neurosurgery |
Zdroj: | The Neuroradiology Journal |
ISSN: | 2385-1996 1971-4009 |
Popis: | Background and purpose To investigate the reliability and accuracy of Alberta Stroke Program Early Computed Tomography Scores (ASPECTS) derived from flatpanel detector computed tomography pooled blood volume maps compared to non-contrast computed tomography and multidetector computed tomography perfusion cerebral blood volume maps. Methods ASPECTS from pooled blood volume maps were evaluated retrospectively by two experienced readers for 37 consecutive patients with acute middle cerebral artery (MCA) M1 occlusion who underwent flatpanel detector computed tomography perfusion imaging before mechanical thrombectomy between November 2016 and February 2019. For comparison with ASPECTS from non-contrast computed tomography and cerebral blood volume maps, a matched-pair analysis according to pre-stroke modified Rankin scale, age, stroke severity, site of occlusion, time from stroke onset to imaging and final modified thrombolysis in cerebral infarction (mTICI) was performed in a separate group of patients who underwent multimodal computed tomography prior to mechanical thrombectomy between June 2015 and February 2019. Follow-up ASPECTS were derived from either non-contrast computed tomography or from magnetic resonance imaging (in seven patients) one day after mechanical thrombectomy. Results Interrater agreement was best for non-contrast computed tomography ASPECTS (w-kappa = 0.74, vs. w-kappa = 0.63 for cerebral blood volume ASPECTS and w-kappa = 0.53 for pooled blood volume ASPECTS). Also, accuracy, defined as correlation between acute and follow-up ASPECTS, was best for non-contrast computed tomography ASPECTS (Spearman ρ = 0.86 (0.65–0.97), P Conclusion Non-contrast computed tomography ASPECTS outperformed both pooled blood volume ASPECTS and cerebral blood volume ASPECTS in accuracy and reliability. Importantly, relevant infarct overestimation was observed more often in pooled blood volume ASPECTS than cerebral blood volume ASPECTS, limiting its present clinical applicability for acute stroke imaging. |
Databáze: | OpenAIRE |
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