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Automated Perfusion Calculations vs. Visual Scoring of Collaterals and CBV-ASPECTS
Clinical Neuroradiology ( IF 2.8 ) Pub Date : 2020-11-20 , DOI: 10.1007/s00062-020-00974-3
Marios-Nikos Psychogios 1 , Peter B Sporns 1, 2 , Johanna Ospel 1, 3 , Aristeidis H Katsanos 4, 5 , Reza Kabiri 2 , Fabian A Flottmann 2 , Bijoy K Menon 3 , Mackenzie Horn 3 , David S Liebeskind 6 , Tristan Honda 6 , Marc Ribo 7 , Manuel Requena Ruiz 7 , Christoph Kabbasch 8 , Thorsten Lichtenstein 8 , Christoph J Maurer 9 , Ansgar Berlis 9 , Victoria Hellstern 10 , Hans Henkes 10 , Markus A Möhlenbruch 11 , Fatih Seker 11 , Marielle S Ernst 2 , Jan Liman 12 , Georgios Tsivgoulis 5, 13 , Alex Brehm 1
Affiliation  

Purpose

Use of automated perfusion software has gained importance for imaging of stroke patients for mechanical thrombectomy (MT). We aim to compare four perfusion software packages: 1) with respect to their association with 3‑month functional outcome after successful reperfusion with MT in comparison to visual Cerebral Blood Volume - Alberta Stroke Program Early CT Score (CBV-ASPECTS) and collateral scoring and 2) with respect to their agreement in estimation of core and penumbra volume.

Methods

This retrospective, multicenter cohort study (2015–2019) analyzed data from 8 centers. We included patients who were functionally independent before and underwent successful MT of the middle cerebral artery. Primary outcome measurements were the relationship of core and penumbra volume calculated by each software, qualitative assessment of collaterals and CBV-APECTS with 3‑month functional outcome and disability (modified Rankin scale >2). Quantitative differences between perfusion software measurements were also assessed.

Results

A total of 215 patients (57% women, median age 77 years) from 8 centers fulfilled the inclusion criteria. Multivariable analyses showed a significant association of RAPID core (common odds ratio, cOR 1.02; p = 0.015), CBV-ASPECTS (cOR 0.78; p = 0.007) and collaterals (cOR 0.78; p = 0.001) with 3‑month functional outcome (shift analysis), while RAPID core (OR 1.02; p = 0.018), CBV-ASPECTS (OR 0.77; p = 0.024), collaterals (OR 0.78; p = 0.007) and OLEA core (OR 1.02; p = 0.029) were significantly associated with 3‑month functional disability. Mean differences on core estimates between VEOcore and RAPID were 13.4 ml, between syngo.via and RAPID 30.0 ml and between OLEA and RAPID −3.2 ml.

Conclusion

Collateral scoring, CBV-ASPECTS and RAPID were independently associated with functional outcome at 90 days. Core and Penumbra estimates using automated software packages varied significantly and should therefore be used with caution.



中文翻译:

自动灌注计算与抵押品和 CBV-ASPECTS 的视觉评分

目的

自动灌注软件的使用对于机械血栓切除术 (MT) 中风患者的成像变得越来越重要。我们旨在比较四种灌注软件包:1) 与视觉脑血容量相比,它们与 MT 成功再灌注后 3 个月功能结果的关联 - 阿尔伯塔中风计划早期 CT 评分 (CBV-ASPECTS) 和侧支评分以及2) 关于他们在估计核心和半影体积方面的一致。

方法

这项回顾性多中心队列研究(2015-2019 年)分析了来自 8 个中心的数据。我们纳入了之前功能独立并成功接受大脑中动脉 MT 的患者。主要结果测量是每个软件计算的核心和半影体积的关系、侧枝的定性评估和 CBV-APECTS 与 3 个月的功能结果和残疾(改良 Rankin 量表 >2)。还评估了灌注软件测量值之间的定量差异。

结果

来自 8 个中心的 215 名患者(57% 女性,中位年龄 77 岁)符合纳入标准。多变量分析显示 RAPID 核心(共同优势比,cOR 1.02;p  = 0.015)、CBV-ASPECTS(cOR 0.78;p  = 0.007)和侧支(cOR 0.78;p  = 0.001)与 3 个月的功能结果(移位分析),而 RAPID 核心(OR 1.02;p  = 0.018)、CBV-ASPECTS(OR 0.77;p  = 0.024)、抵押品(OR 0.78;p  = 0.007)和 OLEA 核心(OR 1.02;p = 0.029) 与 3 个月的功能障碍显着相关。VEOcore 和 RAPID 之间的岩心估计平均差异为 13.4 ml,syngo.via 和 RAPID 之间为 30.0 ml,OLEA 和 RAPID 之间为 -3.2 ml。

结论

附带评分、CBV-ASPECTS 和 RAPID 与 90 天时的功能结果独立相关。使用自动化软件包的 Core 和 Penumbra 估计差异很大,因此应谨慎使用。

更新日期:2020-11-21
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