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<meta name="DC.Title" content="CT Angiography Source Images Predict Final Infarct Extent in Patients with Basilar Artery Occlusion" />
<meta name="DC.Identifier" content="10.3174/ajnr.A1723" />
<meta name="DC.Date" content="2009-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology. 
Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The posterior circulation Acute Stroke Prognosis Early CT Score (pc-ASPECTS) is a 10-point grading system to quantify ischemic changes in the posterior circulation. We analyzed whether pc-ASPECTS on CT angiography (CTA) source images (CTASI) predicted the final infarct extent and hemorrhagic transformation (HT) rate in patients with basilar artery occlusion.

MATERIALS AND METHODS: A pc-ASPECTS score of 10 indicates absence of visible ischemic changes in the posterior circulation, and pc-ASPECTS score of 0 indicates ischemic changes in the midbrain, pons, and bilateral thalami, posterior circulation territories, and cerebellar hemispheres. We retrospectively studied patients with basilar artery occlusion on CTA within 24 hours from symptom onset. We applied pc-ASPECTS to noncontrast CT (NCCT), CTASI, and follow-up images by 3-reader-consensus and assessed HT on follow-up images. We calculated Spearman correlation coefficients and performed linear regression analysis. Final infarct extent and HT rates were compared across dichotomized CTASI pc-ASPECTS groups (≥ 8 vs &lt; 8).

RESULTS: Among 43 patients, median (range) onset to CTA time was 5.0 hours (range, 0.7–24 hours). Pc-ASPECTS on CTASI ( r = 0.75; P &lt; .001) but not NCCT ( r = 0.29; P = .063) correlated with pc-ASPECTS on follow-up scans. Linear regression demonstrated a significant positive relationship between pc-ASPECTS on CTASI and follow-up scans ( R 2 = 0.58; P &lt; 01). Median follow-up pc-ASPECTS was lower in patients with a CTASI pc-ASPECTS &lt; 8 compared with patients with a CTASI pc-ASPECTS of 8 or more, respectively ( P &lt; .001). HT rates were 27.3% vs 9.5%, respectively ( P = .24). None of 8 patients without thrombolysis had HT on follow-up scans.

CONCLUSIONS: The extent of hypoattenuation on CTASI predicts the final infarct extent in patients with basilar artery occlusion." />
<meta name="DC.Contributor" content="V. Puetz" />
<meta name="DC.Contributor" content="P.N. Sylaja" />
<meta name="DC.Contributor" content="M.D. Hill" />
<meta name="DC.Contributor" content="S.B. Coutts" />
<meta name="DC.Contributor" content="I. Dzialowski" />
<meta name="DC.Contributor" content="U. Becker" />
<meta name="DC.Contributor" content="G. Gahn" />
<meta name="DC.Contributor" content="R. von Kummer" />
<meta name="DC.Contributor" content="A.M. Demchuk" />
<meta name="article:published_time" content="2009-11-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="CT Angiography Source Images Predict Final Infarct Extent in Patients with Basilar Artery Occlusion" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The posterior circulation Acute Stroke Prognosis Early CT Score (pc-ASPECTS) is a 10-point grading system to quantify ischemic changes in the posterior circulation. We analyzed whether pc-ASPECTS on CT angiography (CTA) source images (CTASI) predicted the final infarct extent and hemorrhagic transformation (HT) rate in patients with basilar artery occlusion.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;A pc-ASPECTS score of 10 indicates absence of visible ischemic changes in the posterior circulation, and pc-ASPECTS score of 0 indicates ischemic changes in the midbrain, pons, and bilateral thalami, posterior circulation territories, and cerebellar hemispheres. We retrospectively studied patients with basilar artery occlusion on CTA within 24 hours from symptom onset. We applied pc-ASPECTS to noncontrast CT (NCCT), CTASI, and follow-up images by 3-reader-consensus and assessed HT on follow-up images. We calculated Spearman correlation coefficients and performed linear regression analysis. Final infarct extent and HT rates were compared across dichotomized CTASI pc-ASPECTS groups (≥ 8 vs &amp;lt; 8).&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Among 43 patients, median (range) onset to CTA time was 5.0 hours (range, 0.7–24 hours). Pc-ASPECTS on CTASI (&lt;i&gt;r&lt;/i&gt; = 0.75; &lt;i&gt;P&lt;/i&gt; &amp;lt; .001) but not NCCT (&lt;i&gt;r&lt;/i&gt; = 0.29; &lt;i&gt;P&lt;/i&gt; = .063) correlated with pc-ASPECTS on follow-up scans. Linear regression demonstrated a significant positive relationship between pc-ASPECTS on CTASI and follow-up scans (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.58; &lt;i&gt;P&lt;/i&gt; &amp;lt; 01). Median follow-up pc-ASPECTS was lower in patients with a CTASI pc-ASPECTS &amp;lt; 8 compared with patients with a CTASI pc-ASPECTS of 8 or more, respectively (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001). HT rates were 27.3% vs 9.5%, respectively (&lt;i&gt;P&lt;/i&gt; = .24). None of 8 patients without thrombolysis had HT on follow-up scans.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The extent of hypoattenuation on CTASI predicts the final infarct extent in patients with basilar artery occlusion.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_author" content="V. Puetz" />
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<meta name="citation_reference" content="citation_journal_title=Stroke;citation_author=PJ. Lindsberg;citation_author=HP. Mattle;citation_title=Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis;citation_volume=37;citation_year=2006;citation_pmid=16439705;citation_doi=10.1161/01.STR.0000202582.29510.6b" />
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<meta name="twitter:title" content="CT Angiography Source Images Predict Final Infarct Extent in Patients with Basilar Artery Occlusion" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The posterior circulation Acute Stroke Prognosis Early CT Score (pc-ASPECTS) is a 10-point grading system to quantify ischemic changes in the posterior circulation. We analyzed whether pc-ASPECTS on CT angiography (CTA) source images (CTASI) predicted the final infarct extent and hemorrhagic transformation (HT) rate in patients with basilar artery occlusion.

MATERIALS AND METHODS: A pc-ASPECTS score of 10 indicates absence of visible ischemic changes in the posterior circulation, and pc-ASPECTS score of 0 indicates ischemic changes in the midbrain, pons, and bilateral thalami, posterior circulation territories, and cerebellar hemispheres. We retrospectively studied patients with basilar artery occlusion on CTA within 24 hours from symptom onset. We applied pc-ASPECTS to noncontrast CT (NCCT), CTASI, and follow-up images by 3-reader-consensus and assessed HT on follow-up images. We calculated Spearman correlation coefficients and performed linear regression analysis. Final infarct extent and HT rates were compared across dichotomized CTASI pc-ASPECTS groups (≥ 8 vs &lt; 8).

RESULTS: Among 43 patients, median (range) onset to CTA time was 5.0 hours (range, 0.7–24 hours). Pc-ASPECTS on CTASI ( r = 0.75; P &lt; .001) but not NCCT ( r = 0.29; P = .063) correlated with pc-ASPECTS on follow-up scans. Linear regression demonstrated a significant positive relationship between pc-ASPECTS on CTASI and follow-up scans ( R 2 = 0.58; P &lt; 01). Median follow-up pc-ASPECTS was lower in patients with a CTASI pc-ASPECTS &lt; 8 compared with patients with a CTASI pc-ASPECTS of 8 or more, respectively ( P &lt; .001). HT rates were 27.3% vs 9.5%, respectively ( P = .24). None of 8 patients without thrombolysis had HT on follow-up scans.

CONCLUSIONS: The extent of hypoattenuation on CTASI predicts the final infarct extent in patients with basilar artery occlusion." />
<meta name="og-title" property="og:title" content="CT Angiography Source Images Predict Final Infarct Extent in Patients with Basilar Artery Occlusion" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/30/10/1877" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The posterior circulation Acute Stroke Prognosis Early CT Score (pc-ASPECTS) is a 10-point grading system to quantify ischemic changes in the posterior circulation. We analyzed whether pc-ASPECTS on CT angiography (CTA) source images (CTASI) predicted the final infarct extent and hemorrhagic transformation (HT) rate in patients with basilar artery occlusion.

MATERIALS AND METHODS: A pc-ASPECTS score of 10 indicates absence of visible ischemic changes in the posterior circulation, and pc-ASPECTS score of 0 indicates ischemic changes in the midbrain, pons, and bilateral thalami, posterior circulation territories, and cerebellar hemispheres. We retrospectively studied patients with basilar artery occlusion on CTA within 24 hours from symptom onset. We applied pc-ASPECTS to noncontrast CT (NCCT), CTASI, and follow-up images by 3-reader-consensus and assessed HT on follow-up images. We calculated Spearman correlation coefficients and performed linear regression analysis. Final infarct extent and HT rates were compared across dichotomized CTASI pc-ASPECTS groups (≥ 8 vs &lt; 8).

RESULTS: Among 43 patients, median (range) onset to CTA time was 5.0 hours (range, 0.7–24 hours). Pc-ASPECTS on CTASI ( r = 0.75; P &lt; .001) but not NCCT ( r = 0.29; P = .063) correlated with pc-ASPECTS on follow-up scans. Linear regression demonstrated a significant positive relationship between pc-ASPECTS on CTASI and follow-up scans ( R 2 = 0.58; P &lt; 01). Median follow-up pc-ASPECTS was lower in patients with a CTASI pc-ASPECTS &lt; 8 compared with patients with a CTASI pc-ASPECTS of 8 or more, respectively ( P &lt; .001). HT rates were 27.3% vs 9.5%, respectively ( P = .24). None of 8 patients without thrombolysis had HT on follow-up scans.

CONCLUSIONS: The extent of hypoattenuation on CTASI predicts the final infarct extent in patients with basilar artery occlusion." />
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      <h1 class="highwire-cite-title" id="page-title">CT Angiography Source Images Predict Final Infarct Extent in Patients with Basilar Artery Occlusion</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">V. Puetz</span>, <span class="highwire-citation-author" data-delta="1">P.N. Sylaja</span>, <span class="highwire-citation-author" data-delta="2">M.D. Hill</span>, <span class="highwire-citation-author" data-delta="3">S.B. Coutts</span>, <span class="highwire-citation-author" data-delta="4">I. Dzialowski</span>, <span class="highwire-citation-author" data-delta="5">U. Becker</span>, <span class="highwire-citation-author" data-delta="6">G. Gahn</span>, <span class="highwire-citation-author" data-delta="7">R. von Kummer</span> and <span class="highwire-citation-author" data-delta="8">A.M. Demchuk</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2009,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">30 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1877-1883; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A1723 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-8375--6955148389" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">V. Puetz </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=V.%2BPuetz%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Puetz%20V&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AV.%2BPuetz%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">P.N. 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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> The posterior circulation Acute Stroke Prognosis Early CT Score (pc-ASPECTS) is a 10-point grading system to quantify ischemic changes in the posterior circulation. We analyzed whether pc-ASPECTS on CT angiography (CTA) source images (CTASI) predicted the final infarct extent and hemorrhagic transformation (HT) rate in patients with basilar artery occlusion.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> A pc-ASPECTS score of 10 indicates absence of visible ischemic changes in the posterior circulation, and pc-ASPECTS score of 0 indicates ischemic changes in the midbrain, pons, and bilateral thalami, posterior circulation territories, and cerebellar hemispheres. We retrospectively studied patients with basilar artery occlusion on CTA within 24 hours from symptom onset. We applied pc-ASPECTS to noncontrast CT (NCCT), CTASI, and follow-up images by 3-reader-consensus and assessed HT on follow-up images. We calculated Spearman correlation coefficients and performed linear regression analysis. Final infarct extent and HT rates were compared across dichotomized CTASI pc-ASPECTS groups (≥ 8 vs &lt; 8).</p>
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<p id="p-4"><strong>RESULTS:</strong> Among 43 patients, median (range) onset to CTA time was 5.0 hours (range, 0.7–24 hours). Pc-ASPECTS on CTASI (<em>r</em> = 0.75; <em>P</em> &lt; .001) but not NCCT (<em>r</em> = 0.29; <em>P</em> = .063) correlated with pc-ASPECTS on follow-up scans. Linear regression demonstrated a significant positive relationship between pc-ASPECTS on CTASI and follow-up scans (<em>R</em><sup>2</sup> = 0.58; <em>P</em> &lt; 01). Median follow-up pc-ASPECTS was lower in patients with a CTASI pc-ASPECTS &lt; 8 compared with patients with a CTASI pc-ASPECTS of 8 or more, respectively (<em>P</em> &lt; .001). HT rates were 27.3% vs 9.5%, respectively (<em>P</em> = .24). None of 8 patients without thrombolysis had HT on follow-up scans.</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> The extent of hypoattenuation on CTASI predicts the final infarct extent in patients with basilar artery occlusion.</p>
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      <div class="highwire-cite-title">CT Angiography Source Images Predict Final Infarct Extent in Patients with Basilar Artery Occlusion</div>  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Puetz</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">P.N.</span> <span class="nlm-surname">Sylaja</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.D.</span> <span class="nlm-surname">Hill</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.B.</span> <span class="nlm-surname">Coutts</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">I.</span> <span class="nlm-surname">Dzialowski</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">U.</span> <span class="nlm-surname">Becker</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Gahn</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">R.</span> <span class="nlm-surname">von Kummer</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">A.M.</span> <span class="nlm-surname">Demchuk</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2009, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">30 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1877-1883; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A1723 </span></div>
  
  
  
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