J Stroke.  2021 Sep;23(3):440-442. 10.5853/jos.2021.00458.

Reassessing Alberta Stroke Program Early CT Score on Non-Contrast CT Based on Degree and Extent of Ischemia

• Ospel JM
• Menon BK
• Marko M
• Mayank A
• Ganesh A
• Nogueira RG
• McTaggart RA
• Demchuk AM
• Poppe AY
• Rempel JL
• Joshi M
• Almekhlafi MA
• Zerna C
• Tymianski M
• Hill MD
• Goyal M
• the ESCAPE-NA1 investigators

• KMID: 2520921
• DOI: http://doi.org/10.5853/jos.2021.00458

Figure

• 

  Figure 1. Examples for conventional and reassessed Alberta Stroke Program Early CT Score (ASPECTS). (A) The entire right lentiform nucleus is clearly hypodense (grey line). Thus, a full point would be subtracted in conventional ASPECTS and reassessed ASPECTS. (B) The entire right lentiform nucleus is slightly hypodense compared to the left side (dashed grey line). Thus, a full point would be subtracted in conventional ASPECTS; 0.5 point would be subtracted when reassessing ASPECTS. (C) Some parts of the left lentiform nucleus are clearly hypodense (grey line) while the density in other parts is preserved. Thus, a full point would be subtracted with conventional ASPECTS versus 0.5 point when reassessing ASPECTS.

• 

  Figure 2. Distribution of conventional and reassessed Alberta Stroke Program Early CT Score (ASPECTS). (A) Scatter-plot showing medians and interquartile ranges of reassessed scores (y-axis) for each ASPECTS value (x-axis). The grey line is fitted from a simple linear regression. (B) Bland Altman plot showing agreement between conventional and reassessed ASPECTS. Central dashed line: average difference (1.2 units) between reassessed and conventional ASPECTS. Lower and upper dashed lines show limits of agreement (–1.5 to 3.9).

Reference

References

1. Logan C, Maingard J, Phan K, Motyer R, Barras C, Looby S, et al. Borderline Alberta Stroke Programme Early CT Score patients with acute ischemic stroke due to large vessel occlusion may find benefit with endovascular thrombectomy. World Neurosurg. 2018; 110:e653–e658.

2. Hill MD, Goyal M, Menon BK, Nogueira RG, McTaggart RA, Demchuk AM, et al. Efficacy and safety of nerinetide for the treatment of acute ischaemic stroke (ESCAPE-NA1): a multicentre, double-blind, randomised controlled trial. Lancet. 2020; 395:878–887.

3. Aarts M, Liu Y, Liu L, Besshoh S, Arundine M, Gurd JW, et al. Treatment of ischemic brain damage by perturbing NMDA receptor- PSD-95 protein interactions. Science. 2002; 298:846–850.

4. Menon BK, d’Esterre CD, Qazi EM, Almekhlafi M, Hahn L, Demchuk AM, et al. Multiphase CT angiography: a new tool for the imaging triage of patients with acute ischemic stroke. Radiology. 2015; 275:510–520.

5. Saposnik G, Menon BK, Kashani N, Wilson AT, Yoshimura S, Campbell BCV, et al. Factors associated with the decisionmaking on endovascular thrombectomy for the management of acute ischemic stroke. Stroke. 2019; 50:2441–2447.