학술논문
The use of e-ASPECTS in acute stroke care: validation of method performance compared to the performance of specialists.
Document Type
Academic Journal
Author
Ferreti LA; Universidade Federal do Paraná, Curitiba PR, Brazil.; Leitao CA; Universidade Federal do Paraná, Curitiba PR, Brazil.; Teixeira BCA; Universidade Federal do Paraná, Curitiba PR, Brazil.; Lopes Neto FDN; Universidade Federal do Paraná, Curitiba PR, Brazil.; ZÉtola VF; Universidade Federal do Paraná, Curitiba PR, Brazil.; Lange MC; Universidade Federal do Paraná, Curitiba PR, Brazil.
Source
Publisher: Thieme Country of Publication: Germany NLM ID: 0125444 Publication Model: Print Cited Medium: Internet ISSN: 1678-4227 (Electronic) Linking ISSN: 0004282X NLM ISO Abbreviation: Arq Neuropsiquiatr Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The rapid evaluation of non-contrast-enhanced computed tomography (NCCT) brain scans in patients with anterior stroke symptoms saves time and favors optimal and prompt treatment. e-ASPECTS is a tool that automatically calculates the Alberta Stroke Program Early CT Score (ASPECTS) values, leading to a more accurate and timely image evaluation.
Objective: To determine the ability of e-ASPECTS in differentiating images with and without injury.
Methods: One-hundred sixteen patients admitted to a stroke unit in a Brazilian tertiary hospital underwent a CT scan at admission and at least one control brain imaging (NCCT or magnetic resonance imaging - MRI) 24 hours after admission. ASPECTS evaluation was performed by three neuroradiologists, three neurologists, and three neurology residents, all blinded to the symptoms and the injury side. The scores were compared to the ground truth, and an ASPECTS score was provided by two independent non blinded evaluators. Sensitivity and specificity were analyzed, and receiver operating characteristic curves, Bland-Altman plots with mean error score, and Matthews correlation coefficients (MCCs) were obtained for ASPECTS scores, assuming values equal to 10 for images without injury and values other than 10 for images with ischemic injury.
Results: e-ASPECTS demonstrated similar performance to that of neuroradiologists and neurologists, with an area under the curve of 0.78 and an MCC value of 0.48 in the dichotomous analysis. The sensitivity and specificity of e-ASPECTS were 75% and 73%, respectively.
Conclusion: e-ASPECTS is a validated and reliable tool for determining early signs of ischemia in NCCT.
Objective: To determine the ability of e-ASPECTS in differentiating images with and without injury.
Methods: One-hundred sixteen patients admitted to a stroke unit in a Brazilian tertiary hospital underwent a CT scan at admission and at least one control brain imaging (NCCT or magnetic resonance imaging - MRI) 24 hours after admission. ASPECTS evaluation was performed by three neuroradiologists, three neurologists, and three neurology residents, all blinded to the symptoms and the injury side. The scores were compared to the ground truth, and an ASPECTS score was provided by two independent non blinded evaluators. Sensitivity and specificity were analyzed, and receiver operating characteristic curves, Bland-Altman plots with mean error score, and Matthews correlation coefficients (MCCs) were obtained for ASPECTS scores, assuming values equal to 10 for images without injury and values other than 10 for images with ischemic injury.
Results: e-ASPECTS demonstrated similar performance to that of neuroradiologists and neurologists, with an area under the curve of 0.78 and an MCC value of 0.48 in the dichotomous analysis. The sensitivity and specificity of e-ASPECTS were 75% and 73%, respectively.
Conclusion: e-ASPECTS is a validated and reliable tool for determining early signs of ischemia in NCCT.