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Delayed phase computed tomography angiography ASPECTS predicts clinical outcome and final infarct volume

Authors
 Byung Hoon Lee  ;  Yoon Joon Hwang  ;  Jin Woo Kim 
Citation
 PLOS ONE, Vol.15(9) : e0239510, 2020-09 
Journal Title
 PLOS ONE 
Issue Date
2020-09
MeSH
Aged ; Brain Ischemia / pathology* ; Cerebral Angiography / methods* ; Computed Tomography Angiography / methods* ; Contrast Media / administration & dosage ; Diffusion Magnetic Resonance Imaging / methods ; Female ; Humans ; Infarction / pathology* ; Male ; Retrospective Studies ; Severity of Illness Index ; Stroke / pathology* ; Tomography, X-Ray Computed / methods* ; Treatment Outcome
Abstract
Background and purpose: 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. Methods: We 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. Results: A 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). Conclusion: CTA-DP ASPECTS is a reliable predictor of final infarction core and neurological outcome.
Files in This Item:
T202004648.pdf Download
DOI
10.1371/journal.pone.0239510
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Woo(김진우) ORCID logo https://orcid.org/0000-0003-3155-0569
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180360
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