Attenuation Changes in ASPECTS Regions: A Surrogate for CT Perfusion–based Ischemic Core in Acute Ischemic Stroke Automated measurements of noncontrast.

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Presentation transcript:

Attenuation Changes in ASPECTS Regions: A Surrogate for CT Perfusion–based Ischemic Core in Acute Ischemic Stroke Automated measurements of noncontrast CT x-ray attenuation in Alberta Stroke Program Early CT Score (ASPECTS) regions were tested in two cohorts of patients with acute ischemic stroke due to proximal occlusion. Relative Hounsfield unit (rHU) values, defined as the ratio of regional attenuation (ischemic to non-ischemic hemisphere), yielded the best classification of ischemic core for the caudate nucleus, the lentiform nucleus, and the insula (area under the receiver operating characteristic curve [AUC], 0.70–0.77; P < .001). A composite rHU score combining rHU values from all regions allowed classification of patients with stroke according to CT perfusion selection criteria per current guidelines with AUCs of 0.80 (P = .001) in a test cohort and 0.74 (P < .001) in a validation cohort. Noncontrast CT images without (left) and with (right) superimposed automated segmentation of ASPECTS regions show region mapping and x-ray attenuation measurements. Reidler P et al. Published Online: Mar 19, 2019 https://doi.org/10.1148/radiol.2019182041