Related Experiment Video
Updated: Mar 15, 2026
Dual-Task Stroop Paradigm for Detecting Cognitive Deficits in High-Functioning Stroke Patients
Published on: December 16, 2022
ASPECTS (Alberta Stroke Program Early CT Score) Assessment of the Perfusion-Diffusion Mismatch
Louis Lassalle1, Guillaume Turc1, Marie Tisserand1
1From the Departments of Radiology (L. Lassalle, M.T., S.C., P.R., S.L., L. Legrand, M.E., O.N., J.-F.M., C.O.), and Neurology (G.T., J.-L.M., J.-C.B.), Université Paris Descartes Sorbonne Paris Cité, Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France.
The Alberta Stroke Program Early CT Score (ASPECTS) reliably identifies perfusion-weighted imaging (PWI)/diffusion-weighted imaging (DWI) mismatch in acute stroke patients. This method offers rapid screening for eligible mismatch, aiding clinical decisions.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Accurate assessment of perfusion-weighted imaging (PWI) and diffusion-weighted imaging (DWI) mismatch is crucial for acute stroke management.
- The Alberta Stroke Program Early CT Score (ASPECTS) is a potential tool for evaluating this mismatch.
Purpose of the Study:
- To test the reliability of ASPECTS in identifying the PWI/DWI mismatch in acute stroke patients.
- To determine the optimal mismatch-ASPECTS cutoff for detecting volumetric mismatch.
Main Methods:
- Retrospective evaluation of 232 acute middle cerebral artery stroke patients with pretreatment MRI (PWI and DWI).
- ASPECTS scores (PWI-ASPECTS, DWI-ASPECTS) were determined from segmented imaging volumes.
- Mismatch-ASPECTS was calculated as the difference between PWI-ASPECTS and DWI-ASPECTS.
Main Results:
- High inter-reader agreement for PWI-ASPECTS (κ=0.95) and DWI-ASPECTS (κ=0.96).
- Strong negative correlations between volumetric and ASPECTS-based assessments of DWI (ρ=-0.84) and PWI (ρ=-0.90) lesions.
- A mismatch-ASPECTS ≥2 demonstrated high sensitivity (0.93) and specificity (0.82) for identifying volumetric mismatch.
Conclusions:
- The mismatch-ASPECTS method accurately detects PWI/DWI mismatch in acute stroke.
- This approach facilitates rapid screening of patients with eligible mismatch, particularly in centers lacking advanced postprocessing software.
