PMU-Autor/inn/en
Pfaff JohannesAbstract
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.
Useful keywords (using NLM MeSH Indexing)
Aged
Aged, 80 and over
Alberta
Female
Humans
Image Processing, Computer-Assisted
Infarction, Middle Cerebral Artery/diagnostic imaging*
Infarction, Middle Cerebral Artery/therapy
Male
Mechanical Thrombolysis
Middle Aged
Software*
Stroke/diagnostic imaging*
Tomography, X-Ray Computed/methods*
Treatment Outcome
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