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Title	Reliability of applying the Alberta Stroke Program Early Computed-Tomography Score (ASPECTS) to computed-tomography (CT) and computed-tomography-perfusion (CTP) images in acute ischemic stroke
Author	Magarik, Jordan Asher
Date	2011
Affiliation/College	College of Graduate Studies
Department	Neuroscience
Extent	79 leaves : ill.; 29 cm
Source	QZ 170 M188 2011
Subject.MeSH	Academic Dissertations--South Carolina Stroke
Collection	MUSC Theses and Dissertations
Contributing Institution	Waring Historical Library (MUSC)
Rights	Copyright is held by the author.
Language	English
Type	Text
Format	application/pdf
Media Type	Manuscripts
Resource Identifier	mtd2001_magarik_ja
Abstract	Introduction: The detection and interpretation of early ischemic changes and salvageable brain parenchyma in acute ischemic stroke is critical in determining appropriate treatment. The Alberta Stroke Program Early CT Score (ASPECTS) was devised as a semi-quantitative method to accurately and reliably determine early ischemic changes in non-contrast CT (NCCT) and CT-perfusion (CTP) imaging. Our objective was to determine the inter-observer variability In assigning ASPECTS to admission NCCT, CTP, and follow-up imaging. Methods: A retrospective study was performed of imaging and clinical data obtained for ischemic stroke patients admitted to the MUSC stroke center between October 1, 2008 - September 30, 2009. Patients were included in the study if they: received a good quality CT and CTP at admission and follow-up NCCT and/or MRI within 7 days, had a National Institute of Health Stroke Scale (NIHSS) score ~ 8 at admission, and were ~ 45 years old. Patients were excluded if they: received a primary diagnosis of intracranial hemorrhage, aneurysm, lacunar stroke, or seizure. Two clinicians, a neuroradiologist and a neuro-interventional radiologist, assigned scores to admission NCCT and CTP studies and follow-up NCCT or MRI images. Both were blinded to all clinical information except affected hemisphere.Results: Of the 444 consecutive ischemic stroke patients evaluated, 45 were included based on study criteria. Agreement between the two observers for ASPECTS on admission NCCT was 0.61 (95% CI 0.40 - 0.82) when scores were dichotomized s 7 versus >7. On admission CBV, MTT, and CBF interobserver agreement was, 0.71 (95% CI 0.50-0.92), 0.68 (95% CI 0.46-0.91), and 0.63 (95% CI 0.41-0.84), respectively. On follow-up imaging the inter-observer agreement was 0.53 (95% CI 0.30-0.75).

Reliability of applying the Alberta Stroke Program Early Computed-Tomography Score (ASPECTS) to computed-tomography (CT) and computed-tomography-perfusion (CTP) images in acute ischemic stroke

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