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Abstract
Background and purposeNon-contrast computed tomography (NCCT) Alberta Stroke Program Early CT Score (ASPECTS) and assessment of collateral flow with multiphase computed tomography angiography (CTA) have been investigated as predictors of clinical outcome in patients with acute ischemic stroke. This study assessed the value of multiphase CTA ASPECTS in predicting final infarction core and clinical outcome in patients undergoing endovascular treatment of acute ischemic stroke.MethodsWe retrospectively studied consecutive patients who underwent multiphase CTA prior to endovascular treatment of acute stroke due to anterior circulation large artery occlusion. Multiphase CTA and final diffusion-weighted imaging (DWI) scans were evaluated by two independent observers for NCCT ASPECTS, acute phase CTA (CTA-AP) ASPECTS, delayed phase CTA (CTA-DP) ASPECTS, and final DWI ASPECTS. Modified Rankin Scale score ≤2 at 3 months was considered a favorable outcome.ResultsA total of 74 patients were analyzed. We found that CTA-DP ASPECTS (r = 0.82; 95% CI, 0.73–0.91; p < 0.001) correlated with final DWI ASPECTS better than NCCT ASPECTS (r = 0.49; 95% CI, 0.39–0.59) and CTA-AP ASPECTS (r = 0.71; 95% CI, 0.64–0.78). Interobserver agreement was higher for CTA-DP ASPECTS (k = 0.84). Good CTA-DP ASPECTS was an independent predictor of favorable outcome (odds ratio, 8.71; 95% CI, 3.71–17.3; p < 0.001).ConclusionCTA-DP ASPECTS is a reliable predictor of final infarction core and neurological outcome.
Highlights
In the treatment of acute ischemic stroke due to anterior circulation large vessel occlusion, endovascular treatment has become the standard therapy [1,2,3]
We found that computed tomography angiography (CTA)-DP Alberta Stroke Program Early CT Score (ASPECTS) (r = 0.82; 95% confidence interval (CI), 0.73–0.91; p < 0.001) correlated with final diffusion-weighted imaging (DWI) ASPECTS better than non-contrast CT (NCCT) ASPECTS (r = 0.49; 95% CI, 0.39–0.59) and CTA-AP ASPECTS (r = 0.71; 95% CI, 0.64–0.78)
Good CTA-DP ASPECTS was an independent predictor of favorable outcome
Summary
Non-contrast computed tomography (NCCT) Alberta Stroke Program Early CT Score (ASPECTS) and assessment of collateral flow with multiphase computed tomography angiography (CTA) have been investigated as predictors of clinical outcome in patients with acute ischemic stroke. This study assessed the value of multiphase CTA ASPECTS in predicting final infarction core and clinical outcome in patients undergoing endovascular treatment of acute ischemic stroke. Data Availability Statement: According to the Ilsan Paik Hospital Institutional Review Board, our data is anonymous but has not been disclosed as it contains sensitive patient identifying information that could infringe confidentiality. Data can be made available upon request to qualified investigators who would be willing to guarantee the confidentiality of the data. Researchers can request the data by contacting the Ilsan Paik Hospital Institutional Review Board (IRB@paik.ac.kr) and corresponding author Professor Jin Woo Kim (sunny-cocktail@hanmail.net)
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