Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study

Lars Peder Pallesen, Johannes Gerber, Imanuel Dzialowski, Erik J R J van der Hoeven, Patrik Michel, Thomas Pfefferkorn, Christoph Ozdoba, L. Jaap Kappelle, Baerbel Wiedemann, Andrei Khomenko, Ale Algra, Michael D. Hill, Ruediger von Kummer, Andrew M. Demchuk, Wouter J. Schonewille, Volker Puetz, A. M. Weber, G. A. Donnan, V. Thijs, A. PeetersG. de Freitas, A. B. Conforto, M. Miranda-Alves, A. Massaro, P. Ijäs, T. Bogoslovsky, P. J. Lindsberg, C. Weimar, J. Benemann, K. Kraywinkel, C. Haverkamp, D. Michalski, C. Weimar, K. Weissenborn, M. Goertler, A. Kloth, A. Bitsch, T. Mieck, J. Machetanz, P. Möller, R. Huber, S. Kaendler, C. Rueckert, H. Audebert, R. Müller, B. Vatankhah, T. Pfefferkorn, T. E. Mayer, K. Szabo, C. Disque, O. Busse, C. Berger, W. Hacke, Y. Schwammenthal, D. Orion, D. Tanne, M. Bergui, E. Pozzati, W. J. Schonewille, E. van der Hoeven, W. J. Schonewille, A. Algra, L. J. Kappelle, G. J. Luijckx, P. Vroomen, M. D. Vergouwen, Y. Roos, J. Stam, P. de Bienfait, F. E. de Leeuw, P. de Kort, P. de Kort, D. Dippel, T. Baird, K. Muir, N. McDougall, J. Pagola, M. Ribo, C. Molina, A. Gonzales, A. Gil-Peralta, B. Norrving, M. Arnold, U. Fischer, J. Gralla, H. Mattle, G. Schroth, P. Michel, S. T. Engelter, S. Wetzel, P. Lyrer, J. Gandjour, N. Michael, R. Baumgartner, B. Tettenborn, H. Hungerbuehler, C. A C Wijman, A. Finley Caulfield, M. Lansberg, N. Schwartz, C. Venkatasubramanian, Z. Garami, S. Bogaard, F. Yatzu, J. Grotta

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

BACKGROUND AND PURPOSE: The posterior circulation Acute Stroke Prognosis Early CT Score (pc-APECTS) applied to CT angiography source images (CTA-SI) predicts the functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS). We assessed the diagnostic and prognostic impact of pc-ASPECTS applied to perfusion CT (CTP) in the BASICS registry population. METHODS: We applied pc-ASPECTS to CTA-SI and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) parameter maps of BASICS patients with CTA and CTP studies performed. Hypoattenuation on CTA-SI, relative reduction in CBV or CBF, or relative increase in MTT were rated as abnormal. RESULTS: CTA and CTP were available in 27/592 BASICS patients (4.6%). The proportion of patients with any perfusion abnormality was highest for MTT (93%; 95% confidence interval [CI], 76%-99%), compared with 78% (58%-91%) for CTA-SI and CBF, and 46% (27%-67%) for CBV (P < .001). All 3 patients with a CBV pc-ASPECTS < 8 compared to 6/23 patients with a CBV pc-ASPECTS ≥ 8 had died at 1 month (RR 3.8; 95% CI, 1.9-7.6). CONCLUSION: CTP was performed in a minority of the BASICS registry population. Perfusion disturbances in the posterior circulation were most pronounced on MTT parameter maps. CBV pc-ASPECTS < 8 may indicate patients with high case fatality.

Original languageEnglish (US)
Pages (from-to)384-389
Number of pages6
JournalJournal of Neuroimaging
Volume25
Issue number3
DOIs
StatePublished - May 1 2015

Keywords

  • Basilar artery occlusion
  • CT perfusion
  • Pc-ASPECTS

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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