{"title":"使用阿尔伯塔卒中计划静脉相 CT 早期 CT 评分预测血管内血栓切除术后急性缺血性卒中患者的最终梗死面积和临床预后。","authors":"Zi-Xin Yin, Guang-Chen Shen, Wen-Jing Ni, Shan-Shan Lu, Sheng Liu, Hai-Bin Shi, Xiao-Quan Xu, Fei-Yun Wu","doi":"10.1177/02841851241291928","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is a semi-quantitative tool for evaluating the extent and distribution of early ischemic changes.</p><p><strong>Purpose: </strong>To assess the value of ASPECTS on non-contrast CT (NCCT), arterial-phase CT (APCT), or venous-phase CT (VPCT) in predicting the final infarct core (IC) on follow-up diffusion-weighted imaging (DWI) and the clinical outcomes of patients with acute ischemic stroke (AIS) after endovascular thrombectomy (EVT).</p><p><strong>Material and methods: </strong>In total, 120 patients with AIS who underwent EVT in our center were retrospectively enrolled. Correlations between CT-ASPECTS and follow-up DWI-ASPECTS were analyzed using Spearman's rank correlation coefficient. Mean differences and limit of agreement (LoA) between CT-ASPECTS and follow-up DWI-ASPECTS were assessed using the Bland-Altman plots. Multivariate logistic regression and receiver operating characteristic curve analyses were used to identify independent factors and evaluate their performances in predicting the clinical outcomes.</p><p><strong>Results: </strong>VPCT-ASPECTS exhibited the highest correlation with follow-up DWI-ASPECTS (r = 0.846, <i>P </i>< 0.001), followed by APCT-ASPECTS (r = 0.613, <i>P </i>< 0.001) and NCCT-ASPECTS (r = 0.557, <i>P </i>< 0.001). The mean difference between VPCT-ASPECTS and follow-up DWI-ASPECTS was 0.0 (limit of agreement = -2.1 to 2.1). National Institute of Health Stroke Scale (NIHSS) scores at admission (NIHSS<sub>pre</sub>) (odds ratio [OR]=1.162, 95% confidence interval [CI]=1.063-1.270; <i>P </i>= 0.001) and VPCT-ASPECTS (OR=0.728, 95% CI=0.535-0.991; <i>P </i>= 0.044) were the independent factors associated with clinical outcomes. The combined model integrating NIHSS<sub>pre</sub> and VPCT-ASPECTS exhibited an excellent performance in predicting good clinical outcomes (area under curve [AUC]=0.807; sensitivity=75.0%; specificity=72.3%).</p><p><strong>Conclusion: </strong>VPCT-ASPECTS may be a promising imaging biomarker to predict the final IC and the clinical outcome of the patients with AIS after EVT.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"2841851241291928"},"PeriodicalIF":1.1000,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predicting final infarct size and clinical outcomes in patients with acute ischemic stroke after endovascular thrombectomy using the Alberta Stroke Program early CT score on venous-phase CT.\",\"authors\":\"Zi-Xin Yin, Guang-Chen Shen, Wen-Jing Ni, Shan-Shan Lu, Sheng Liu, Hai-Bin Shi, Xiao-Quan Xu, Fei-Yun Wu\",\"doi\":\"10.1177/02841851241291928\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is a semi-quantitative tool for evaluating the extent and distribution of early ischemic changes.</p><p><strong>Purpose: </strong>To assess the value of ASPECTS on non-contrast CT (NCCT), arterial-phase CT (APCT), or venous-phase CT (VPCT) in predicting the final infarct core (IC) on follow-up diffusion-weighted imaging (DWI) and the clinical outcomes of patients with acute ischemic stroke (AIS) after endovascular thrombectomy (EVT).</p><p><strong>Material and methods: </strong>In total, 120 patients with AIS who underwent EVT in our center were retrospectively enrolled. Correlations between CT-ASPECTS and follow-up DWI-ASPECTS were analyzed using Spearman's rank correlation coefficient. Mean differences and limit of agreement (LoA) between CT-ASPECTS and follow-up DWI-ASPECTS were assessed using the Bland-Altman plots. Multivariate logistic regression and receiver operating characteristic curve analyses were used to identify independent factors and evaluate their performances in predicting the clinical outcomes.</p><p><strong>Results: </strong>VPCT-ASPECTS exhibited the highest correlation with follow-up DWI-ASPECTS (r = 0.846, <i>P </i>< 0.001), followed by APCT-ASPECTS (r = 0.613, <i>P </i>< 0.001) and NCCT-ASPECTS (r = 0.557, <i>P </i>< 0.001). The mean difference between VPCT-ASPECTS and follow-up DWI-ASPECTS was 0.0 (limit of agreement = -2.1 to 2.1). National Institute of Health Stroke Scale (NIHSS) scores at admission (NIHSS<sub>pre</sub>) (odds ratio [OR]=1.162, 95% confidence interval [CI]=1.063-1.270; <i>P </i>= 0.001) and VPCT-ASPECTS (OR=0.728, 95% CI=0.535-0.991; <i>P </i>= 0.044) were the independent factors associated with clinical outcomes. The combined model integrating NIHSS<sub>pre</sub> and VPCT-ASPECTS exhibited an excellent performance in predicting good clinical outcomes (area under curve [AUC]=0.807; sensitivity=75.0%; specificity=72.3%).</p><p><strong>Conclusion: </strong>VPCT-ASPECTS may be a promising imaging biomarker to predict the final IC and the clinical outcome of the patients with AIS after EVT.</p>\",\"PeriodicalId\":7143,\"journal\":{\"name\":\"Acta radiologica\",\"volume\":\" \",\"pages\":\"2841851241291928\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2024-11-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta radiologica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/02841851241291928\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta radiologica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/02841851241291928","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Predicting final infarct size and clinical outcomes in patients with acute ischemic stroke after endovascular thrombectomy using the Alberta Stroke Program early CT score on venous-phase CT.
Background: The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is a semi-quantitative tool for evaluating the extent and distribution of early ischemic changes.
Purpose: To assess the value of ASPECTS on non-contrast CT (NCCT), arterial-phase CT (APCT), or venous-phase CT (VPCT) in predicting the final infarct core (IC) on follow-up diffusion-weighted imaging (DWI) and the clinical outcomes of patients with acute ischemic stroke (AIS) after endovascular thrombectomy (EVT).
Material and methods: In total, 120 patients with AIS who underwent EVT in our center were retrospectively enrolled. Correlations between CT-ASPECTS and follow-up DWI-ASPECTS were analyzed using Spearman's rank correlation coefficient. Mean differences and limit of agreement (LoA) between CT-ASPECTS and follow-up DWI-ASPECTS were assessed using the Bland-Altman plots. Multivariate logistic regression and receiver operating characteristic curve analyses were used to identify independent factors and evaluate their performances in predicting the clinical outcomes.
Results: VPCT-ASPECTS exhibited the highest correlation with follow-up DWI-ASPECTS (r = 0.846, P < 0.001), followed by APCT-ASPECTS (r = 0.613, P < 0.001) and NCCT-ASPECTS (r = 0.557, P < 0.001). The mean difference between VPCT-ASPECTS and follow-up DWI-ASPECTS was 0.0 (limit of agreement = -2.1 to 2.1). National Institute of Health Stroke Scale (NIHSS) scores at admission (NIHSSpre) (odds ratio [OR]=1.162, 95% confidence interval [CI]=1.063-1.270; P = 0.001) and VPCT-ASPECTS (OR=0.728, 95% CI=0.535-0.991; P = 0.044) were the independent factors associated with clinical outcomes. The combined model integrating NIHSSpre and VPCT-ASPECTS exhibited an excellent performance in predicting good clinical outcomes (area under curve [AUC]=0.807; sensitivity=75.0%; specificity=72.3%).
Conclusion: VPCT-ASPECTS may be a promising imaging biomarker to predict the final IC and the clinical outcome of the patients with AIS after EVT.
期刊介绍：
Acta Radiologica publishes articles on all aspects of radiology, from clinical radiology to experimental work. It is known for articles based on experimental work and contrast media research, giving priority to scientific original papers. The distinguished international editorial board also invite review articles, short communications and technical and instrumental notes.
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