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Modified Pediatric ASPECTS Correlates with Infarct Volume in Childhood Arterial Ischemic Stroke

Lauren A Beslow1, Arastoo Vossough, Hisham M Dahmoush

  • 1Division of Neurology, The Children's Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania Philadelphia, PA, USA.

Frontiers in Neurology
|September 28, 2012
PubMed

Insights

The modified pediatric Alberta Stroke Program Early CT Score (modASPECTS) on MRI accurately estimates infarct volume in children with arterial ischemic stroke (AIS). This score shows high validity and reliability among raters for assessing stroke severity.

Area of Science:

  • Pediatric neurology
  • Neuroradiology
  • Stroke imaging

Background:

  • Larger infarct volume in childhood arterial ischemic stroke (AIS) correlates with poor outcomes.
  • In perinatal AIS, modified pediatric Alberta Stroke Program Early CT Score (modASPECTS) on MRI predicts seizures.
  • Estimating infarct volume is crucial for predicting outcomes in pediatric AIS.

Purpose of the Study:

  • To determine the relationship between modASPECTS and infarct volume in perinatal and childhood AIS.
  • To establish the interrater reliability of the modASPECTS in pediatric AIS.

Main Methods:

  • Cross-sectional study of 71 neonates and children with supratentorial AIS.
  • Infarct volume calculated as a percentage of supratentorial brain volume (SBV) using MRI.
  • ModASPECTS assessed on diffusion-weighted imaging (DWI) by three independent raters.

Main Results:

  • ModASPECTS demonstrated a strong correlation with infarct volume in both perinatal (ρ=0.87) and childhood (ρ=0.80) AIS groups.
  • High interrater reliability was observed for modASPECTS: ICC=0.93 for neonates and ICC=0.94 for children.
  • Excluding cases of multifocal punctate ischemia strengthened the correlation between modASPECTS and infarct volume.

Conclusions:

  • The modASPECTS on acute MRI is a valid tool for estimating infarct volume in pediatric AIS.
  • The modASPECTS exhibits high interrater reliability, making it a dependable scoring system.
  • This score aids in assessing stroke severity and predicting outcomes in young patients.
Abstract

Keywords:
MRIarterial ischemic strokechildhoodinfarct volumemodified pediatric ASPECTSperinatal

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