Purpose

To compare the evaluation of collaterals on multiphase computed tomography (CT) angiography using the score proposed by the reference study by Menon et al. and the Alberta Stroke Program Early CT (ASPECT) score for the prediction of favorable clinical outcome in patients with anterior ischemic stroke (IS).

Materials and methods

Retrospective single center study including 199 patients with anterior ischemic stroke and evaluated using multiphase CT angiography. Collaterals were assessed using the reference score and ASPECT score. The early clinical outcome [National Institute of Health Stroke Score (NIHSS) over day 1] and later clinical outcome [90-day modified Rankin Scale (mRS)] were collected. The primary analysis related to the association between collateral scores and clinical outcome.

Results

Collaterals are an independent predictive factor of favorable clinical outcome with the two scores, ranging from an odds ratio (OR) [95% confidence interval (CI)] = 1.84 [1.23; 2.76], P = 0.003 for the reference score to an OR [95% CI] = 2.63 [1.21; 5.73], p = 0.015 for the phase 3 ASPECT score. The phase 3 ASPECT score offers better sensitivity (Se) for the prediction of a favorable clinical outcome [Se = 95%, specificity (Sp) = 37% for a threshold of 7/7] than the reference score (Se = 83%, Sp = 47% for a threshold of 4/5).

Conclusion

This study demonstrates the value of the ASPECT score in analyzing collaterals using multiphase CT angiography for the prediction of clinical outcome.

中文翻译：

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前部缺血性卒中：通过使用多期 CT 血管造影检查脑侧支循环，比较两种临床结果预测评分

目的

使用 Menon 等人的参考研究提出的评分比较多相计算机断层扫描 (CT) 血管造影对侧支的评估。和艾伯塔脑卒中计划早期 CT (ASPECT) 评分，用于预测前壁缺血性脑卒中 (IS) 患者的良好临床结果。

材料和方法

回顾性单中心研究包括 199 名前壁缺血性卒中患者，并使用多相 CT 血管造影术进行评估。使用参考分数和 ASPECT 分数评估抵押品。收集了早期临床结果 [第 1 天美国国立卫生研究院卒中评分 (NIHSS)] 和后期临床结果 [90 天改良 Rankin 量表 (mRS)]。主要分析涉及侧支评分与临床结果之间的关联。

结果

抵押品是两个评分的良好临床结果的独立预测因素，范围从优势比 (OR) [95% 置信区间 (CI)] = 1.84 [1.23; 2.76]，P  = 0.003，OR [95% CI] = 2.63 [1.21; 5.73]，第 3 阶段 ASPECT 分数的 p = 0.015。与参考评分（Se = 83%，阈值为 7/7）相比，3 期 ASPECT 评分提供了更好的预测有利临床结果的灵敏度 (Se) [Se = 95%，特异性 (Sp) = 37%，对于 4/5 的阈值，Sp = 47%）。

结论

本研究证明了 ASPECT 评分在使用多相 CT 血管造影术分析侧支循环以预测临床结果方面的价值。