Accuracy of the Alberta Stroke Program Early CT Score during the First 3 Hours of Middle Cerebral Artery Stroke: Comparison of Noncontrast CT, CT Angiography Source Images, and CT Perfusion

Lin, Ke; Rapalino, Otto; Law, Meng; Babb, James S.; Siller, K; Pramanik, Bidyut K.

doi:10.3174/ajnr.a0975

Cited by 97 publications

(66 citation statements)

References 20 publications

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“…In ASPECTS topography, the MCA territory was divided into 10 regions (caudate, lentiform nucleus, internal capsule, insula, and M1-M6). [13][14][15] The ASPECTSs of arterial phase and venous phase CTP-SIs were reviewed first, and CBF and CBV were interpreted at least 1 week later to limit potential recall bias. The raters assessed the imaging independently, blinded to clinical information, and did not know follow-up imaging results.…”

Section: Imaging Analysismentioning

confidence: 99%

Identification of Infarct Core and Penumbra in Acute Stroke Using CT Perfusion Source Images

Wang¹,

Gao²,

Xue³

et al. 2009

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:CT perfusion (CTP) mapping has been reported to be useful in the differentiation of the infarct core and ischemic penumbra. However, the value of the CTP source imaging (CTP-SI) during the arterial and venous phases has not been fully investigated. The purpose of this study was to develop a CTP-SI methodology for acute ischemic stroke and compare its efficacy with cerebral blood flow (CBF) and cerebral blood volume (CBV) in predicting infarct core and penumbra.

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Section: Imaging Analysismentioning

confidence: 99%

Identification of Infarct Core and Penumbra in Acute Stroke Using CT Perfusion Source Images

Wang¹,

Gao²,

Xue³

et al. 2009

AJNR Am J Neuroradiol

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“…Both CT angiography and MR angiography can be used to characterize intravascular thrombi. CT perfusion is a functional imaging technique that can be used to identify salvageable brain tissue [1,2]. Diffusion-weighted MR imaging can be used for identifying infarcted brain tissue that is irreversibly damaged, whereas perfusion-weighted MR imaging can be used for identifying reversibly injured ischemic brain tissue [3].…”

Section: Introductionmentioning

confidence: 99%

Computer-Aided Diagnosis of Hyperacute Stroke with Thrombolysis Decision Support Using a Contralateral Comparative Method of CT Image Analysis

et al. 2014

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New and improved techniques have been continuously introduced into CT and MR imaging modalities for the diagnosis and therapy planning of acute stroke. Nevertheless, non-contrast CT (NCCT) is almost always used by every institution as the front line diagnostic imaging modality due to its high affordability and availability. Consequently, the potential reward of extracting as much clinical information as possible from NCCT images can be very great. Intravenous tissue plasminogen activator (tPA) has become the gold standard for treating acute ischemic stroke because it is the only acute stroke intervention approved by the FDA. ASPECTS scoring based on NCCT images has been shown to be a reliable scoring method that helps physicians to make sound decisions regarding tPA administration. In order to further reduce inter-observer variation, we have developed the first end-to-end automatic ASPECTS scoring system using a novel method of contralateral comparison. Due to the self-adaptive nature of the method, our system is robust and has good generalizability. ROC analysis based on evaluation of 103 subjects who presented to the stroke center of Chang Gung Memorial Hospital with symptoms of acute stroke has shown that our system's dichromatic classification of patients into thrombolysis indicated or thrombolysis contraindicated groups has achieved a high accuracy rate with AUC equal to 90.2 %. The average processing time for a single case is 170 s. In conclusion, our system has the potential of enhancing quality of care and providing clinical support in the setting of a busy stroke or emergency center.

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“…Accurate inspection of CTA-SI with narrow windows enables definition of the ischemic core with the additional advantage of whole brain coverage. identifying infarct "core" compared with unenhanced CT has been unequivocally established in multiple studies 2,3 . Theoretical modeling indicates that CTA-SI obtained using early generation protocols generates predominantly blood volume-weighted rather than blood flowweighted images.…”

mentioning

confidence: 99%

“…Thus, radiologists should interpret CTP maps in conjunction with CTA-SI data. Finally, it is again worth underscoring that with the newer, more flow-weighted CTA protocols, not every acute CTA-SI hypodense ischemic lesion is destined to infarct; a substantial portion of a CTA-SI hypodense lesion may reflect "at-risk" ischemic penumbra, or even benign oligemia 3 . Moreover, Kamalian et al 4 reported that CBF maps optimally correlate with admission diffusion-weighted imaging.…”

mentioning

confidence: 99%

CT Angiography Source-Images and CT Perfusion: Are They Complementary Tools for Ischemic Stroke Evaluation?

et al. 2014

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Accuracy of the Alberta Stroke Program Early CT Score during the First 3 Hours of Middle Cerebral Artery Stroke: Comparison of Noncontrast CT, CT Angiography Source Images, and CT Perfusion

Cited by 97 publications

References 20 publications

Identification of Infarct Core and Penumbra in Acute Stroke Using CT Perfusion Source Images

Identification of Infarct Core and Penumbra in Acute Stroke Using CT Perfusion Source Images

Computer-Aided Diagnosis of Hyperacute Stroke with Thrombolysis Decision Support Using a Contralateral Comparative Method of CT Image Analysis

CT Angiography Source-Images and CT Perfusion: Are They Complementary Tools for Ischemic Stroke Evaluation?

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