OBJECTIVES The clinical utility of electronically derived ASPECTS (e-ASPECTS) to quantify signs of acute ischemic infarction could be demonstrated in multiple studies. Here, we aim to clinically validate the impact of CT slice thickness (ST) on the performance of e-ASPECTS software. METHODS A consecutive series of n = 258 patients (06/2016 and 01/2019) with middle cerebral artery occlusion and subsequent treatment with mechanical thrombectomy was analyzed. The e-ASPECTS score and acute infarct volumes were calculated from baseline non-contrast CT with a software using 1-mm slice thickness (ST) (defined as ground truth) and axial reconstructions with 2-10-mm ST and correlated with baseline stroke severity (NIHSS) as well as clinical outcome (mRS) using logistic regressions. RESULTS In comparison with the ground truth, significant differences were seen in e-ASPECTS scores with ST > 6 mm (p ≤ 0.031) and infarct volumes with ST > 4 mm (p ≤ 0.001). There was a significant correlation of lower e-ASPECTS and higher acute infarct volumes with increasing baseline NIHSS values for all ST (p ≤ 0.001, respectively), with values derived from 1 mm yielding the highest correlation for both parameters (rho, - 0.38 and 0.31, respectively). Similarly, lower e-ASPECTS and higher acute infarct volumes from all ST were significantly associated with poor outcome after 90 days (p ≤ 0.05, respectively) with values derived from 1-mm ST yielding the highest effects for both parameters (OR, 0.69 [95% CI 0.50-0.88] and 1.27 [95% CI 1.10-1.50], respectively). CONCLUSIONS The e-ASPECTS software generates robust values for e-ASPECTS and acute infarct volumes when using ST ≤ 4 mm with ST = 1 mm yielding the best performance for predicting baseline stroke severity and clinical outcome after 90 days. KEY POINTS • Clinical utility of automatically derived ASPECTS from computed tomography scans was shown in patients with acute ischemic stroke and treatment with mechanical thrombectomy. • Thin slices (= 1 mm) had the highest clinical utility in comparison with thicker slices (2-10 mm) by having the strongest correlation with baseline stroke severity and independent effects on clinical outcome after 90 days. • Automatically calculated acute infarct volumes possess clinical utility beyond ASPECTS and should be considered in future studies.

中文翻译：

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切片厚度对自动化艾伯塔中风计划早期计算机断层扫描评分的临床效用的影响。

目标 电子衍生的 ASPECTS (e-ASPECTS) 在量化急性缺血性梗塞迹象方面的临床效用可以在多项研究中得到证实。在这里，我们旨在临床验证 CT 切片厚度 (ST) 对 e-ASPECTS 软件性能的影响。方法 连续分析了 n = 258 名大脑中动脉闭塞患者（06/2016 和 01/2019）并随后接受机械取栓治疗。e-ASPECTS 评分和急性梗死体积是从基线非对比 CT 计算的，使用软件使用 1 毫米切片厚度 (ST)（定义为真实情况）和轴向重建与 2-10 毫米 ST 并与基线卒中相关严重性 (NIHSS) 以及使用逻辑回归的临床结果 (mRS)。结果 与地面实况相比，ST > 6 mm (p ≤ 0.031) 的 e-ASPECTS 评分和 ST > 4 mm (p ≤ 0.001) 的梗死体积存在显着差异。较低的 e-ASPECTS 和较高的急性梗死体积与增加的所有 ST 的基线 NIHSS 值之间存在显着相关性（分别为 p ≤ 0.001），源自 1 mm 的值对两个参数（rho，- 0.38 和0.31，分别）。同样，来自所有 ST 的较低 e-ASPECTS 和较高的急性梗死体积与 90 天后的不良结果显着相关（分别为 p ≤ 0.05），来自 1 mm ST 的值对两个参数产生最高影响（OR，0.69 [ 95% CI 0.50-0.88] 和 1.27 [95% CI 1.10-1.50]）。结论 当使用 ST ≤ 4 mm 且 ST = 1 mm 时，e-ASPECTS 软件为 e-ASPECTS 和急性梗死体积生成稳健值，在预测 90 天后基线卒中严重程度和临床结果方面具有最佳性能。要点 • 从计算机断层扫描自动推导出的 ASPECTS 的临床效用已在急性缺血性卒中和机械取栓治疗的患者中得到证实。• 与较厚的切片（2-10 毫米）相比，薄切片（= 1 毫米）具有最高的临床效用，因为它与基线中风严重程度和 90 天后对临床结果的独立影响具有最强的相关性。• 自动计算的急性梗死体积具有超越 ASPECTS 的临床效用，应在未来的研究中加以考虑。