BACKGROUND: To establish an easy and rapid method for evaluating pial collateral flow, we compared the Alberta Stroke Program Early CT Score (ASPECTS) on nonenhanced CT (NECT), conventional contrast-enhanced CT (CECT), and CT angiography source images (CTA-SI) in patients with acute ischemic stroke. METHODS: We reviewed 55 consecutive patients with acute ischemic stroke involving the anterior circulation who underwent thrombolysis within 6 h of referral to the stroke center. We evaluated axial images using NECT, CECT and CTA-SI. Pial collateral formation was graded as fair (1-2 points) or bad (3-5 points) based on 4-vessel angiography. The outcomes were dichotomized into good (modified Rankin Scale, mRS 0-2) or poor (mRS 3-6) using a 90-day mRS. RESULTS: Demographics (age, sex, initial National Institutes of Health Stroke Scale score, time to CT acquisition and stroke subtypes) did not significantly differ between patients with fair or bad collateral formation. ASPECTS on CECT (r = -0.788, p < 0.0001) was more inversely correlated with pial collateral formation than ASPECTS on NECT (r = -0.557, p < 0.0001) or ASPECTS on CTA-SI (r = -0.662, p < 0.0001). Furthermore, ASPECTS on CECT demonstrated a high discriminative capability, with an area under the receiver operating characteristic curve of 0.885 for fair collateral circulation, compared to 0.790 for ASPECTS on NECT and 0.794 for ASPECTS on CTA-SI. Multiple regression analysis revealed that ASPECTS on CECT (≥8) was an independent predictor for fair collateral circulation (odds ratio = 23.00, p < 0.001) and a good prognosis (odds ratio = 17.81, p < 0.001). CONCLUSION: ASPECTS on CECT is a feasible method for predicting pial collateral flow and overall outcomes in acute ischemic stroke.
BACKGROUND: To establish an easy and rapid method for evaluating pial collateral flow, we compared the Alberta Stroke Program Early CT Score (ASPECTS) on nonenhanced CT (NECT), conventional contrast-enhanced CT (CECT), and CT angiography source images (CTA-SI) in patients with acute ischemic stroke. METHODS: We reviewed 55 consecutive patients with acute ischemic stroke involving the anterior circulation who underwent thrombolysis within 6 h of referral to the stroke center. We evaluated axial images using NECT, CECT and CTA-SI. Pial collateral formation was graded as fair (1-2 points) or bad (3-5 points) based on 4-vessel angiography. The outcomes were dichotomized into good (modified Rankin Scale, mRS 0-2) or poor (mRS 3-6) using a 90-day mRS. RESULTS: Demographics (age, sex, initial National Institutes of Health Stroke Scale score, time to CT acquisition and stroke subtypes) did not significantly differ between patients with fair or bad collateral formation. ASPECTS on CECT (r = -0.788, p < 0.0001) was more inversely correlated with pial collateral formation than ASPECTS on NECT (r = -0.557, p < 0.0001) or ASPECTS on CTA-SI (r = -0.662, p < 0.0001). Furthermore, ASPECTS on CECT demonstrated a high discriminative capability, with an area under the receiver operating characteristic curve of 0.885 for fair collateral circulation, compared to 0.790 for ASPECTS on NECT and 0.794 for ASPECTS on CTA-SI. Multiple regression analysis revealed that ASPECTS on CECT (≥8) was an independent predictor for fair collateral circulation (odds ratio = 23.00, p < 0.001) and a good prognosis (odds ratio = 17.81, p < 0.001). CONCLUSION: ASPECTS on CECT is a feasible method for predicting pial collateral flow and overall outcomes in acute ischemic stroke.
Authors: Mina Park; Kyung-Eun Kim; Na-Young Shin; Seung-Koo Lee; Soo Mee Lim; Dongbeom Song; Ji Hoe Heo; Jin Woo Kim; Se Won Oh Journal: Eur Radiol Date: 2015-09-22 Impact factor: 5.315
Authors: Leonard L L Yeo; Prakash Paliwal; Adrian F Low; Edgar L W Tay; Anil Gopinathan; Mahendran Nadarajah; Eric Ting; Narayanaswamy Venketasubramanian; Raymond C S Seet; Aftab Ahmad; Bernard P L Chan; Hock L Teoh; Derek Soon; Rahul Rathakrishnan; Vijay K Sharma Journal: Neurology Date: 2016-01-06 Impact factor: 9.910
Authors: L L L Yeo; P Paliwal; H L Teoh; R C Seet; B P Chan; E Ting; N Venketasubramanian; W K Leow; B Wakerley; Y Kusama; R Rathakrishnan; V K Sharma Journal: AJNR Am J Neuroradiol Date: 2014-10-16 Impact factor: 3.825
Authors: Na-Young Shin; Kyung-eun Kim; Mina Park; Young Dae Kim; Dong Joon Kim; Sung Jun Ahn; Ji Hoe Heo; Seung-Koo Lee Journal: PLoS One Date: 2014-09-11 Impact factor: 3.240