Correlation of Alberta Stroke Program Early Computed Tomography Score With Computed Tomography Perfusion Core in
Sriharsha Voleti1, Johnathan Vidovich1, Brendan Corcoran1
1Department of Radiology (S.V., J.V., B.C., V.K., T.T., A.V.), University of Cincinnati Medical Center, OH.
Stroke
|January 7, 2021
Summary
Noncontrast CT (NCCT) and CT angiography source images (CTA-SI) ASPECTS show moderate correlation with CT perfusion (CTP) core volumes in acute ischemic stroke. These imaging techniques may aid patient selection when CTP is unavailable.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Acute ischemic stroke management relies on accurate prediction of the ischemic core.
- Alberta Stroke Program Early Computed Tomography (CT) Score (ASPECTS) and CT perfusion (CTP) are established methods.
- CT angiography source images (CTA-SI) offer additional insights into ischemic extent.
Purpose of the Study:
- To investigate the correlation between noncontrast CT (NCCT) ASPECTS and CTA-SI ASPECTS with CTP core volumes.
- To evaluate the utility of NCCT and CTA-SI in predicting ischemic core in acute ischemic stroke patients with large vessel occlusion.
Main Methods:
- Retrospective analysis of 52 acute ischemic stroke patients with large vessel occlusion.
- ASPECTS grading on baseline NCCT and CTA-SI.
- CTP core volume measurement using automated software (cerebral blood flow <30%).
- Spearman's correlation coefficients were used to assess relationships.
Main Results:
- A moderate correlation was found between NCCT ASPECTS and CTP core (rs=-0.55, P<0.0001).
- A moderate correlation was also observed between CTA-SI ASPECTS and CTP core (rs=-0.50, P=0.0002).
- Optimal NCCT ASPECTS cutoff (≥6) and CTA-SI ASPECTS cutoff (≥5) were identified for predicting CTP core volume.
Conclusions:
- NCCT and CTA-SI ASPECTS moderately correlate with CTP-defined ischemic core in delayed time windows.
- Further research is warranted to explore the use of NCCT and CTA for image-based patient selection when CTP is not accessible.
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