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Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study

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Pallesen, Lars-Peder Gerber, Johannes Dzialowski, Imanuel van der Hoeven, Erik J.R.J. Michel, Patrik Peeters, André [UCL]

BACKGROUND AND PURPOSE: The posterior circulation Acute Stroke Prognosis Early CT Score (pc-APECTS) applied to CT angiography source images (CTA-SI) predicts the functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS). We assessed the diagnostic and prognostic impact of pc-ASPECTS applied to perfusion CT (CTP) in the BASICS registry population. METHODS: We applied pc-ASPECTS to CTA-SI and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) parameter maps of BASICS patients with CTA and CTP studies performed. Hypoattenuation on CTA-SI, relative reduction in CBV or CBF, or relative increase in MTT were rated as abnormal. RESULTS: CTA and CTP were available in 27/592 BASICS patients (4.6%). The proportion of patients with any perfusion abnormality was highest for MTT (93%; 95% confidence interval [CI], 76%-99%), compared with 78% (58%-91%) for CTA-SI and CBF, and 46% (27%-67%) for CBV (P < .001). All 3 patients with a CBV pc-ASPECTS < 8 compared to 6/23 patients with a CBV pc-ASPECTS ≥ 8 had died at 1 month (RR 3.8; 95% CI, 1.9-7.6). CONCLUSION: CTP was performed in a minority of the BASICS registry population. Perfusion disturbances in the posterior circulation were most pronounced on MTT parameter maps. CBV pc-ASPECTS < 8 may indicate patients with high case fatality.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2015
Language Anglais
Journal information "Journal of Neuroimaging" - Vol. 25, no. 3, p. 384-389 (2015)
Peer reviewed yes
Publisher Wiley-Blackwell Publishing, Inc.
e-issn 1552-6569
issn 1051-2284
Publication status Publié
Affiliations UCL - (SLuc) Service de neurologie
UCL - SSS/IONS/NEUR - Clinical Neuroscience
Links
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Bibliographic reference Pallesen, Lars-Peder ; Gerber, Johannes ; Dzialowski, Imanuel ; van der Hoeven, Erik J.R.J. ; Michel, Patrik ; et. al. Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study. In: Journal of Neuroimaging, Vol. 25, no. 3, p. 384-389 (2015)
Permanent URL http://hdl.handle.net/2078.1/164359