Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy

摘要: Summary Background Computed tomography (CT) must be done before thrombolytic treatment of hyperacute ischaemic stroke, but the significance early change on CT is unclear. We tested a quantitative score, Alberta Stroke Programme Early Score (ASPECTS). Methods 203 consecutive patients with stroke were treated intravenous alteplase within 3 h symptom onset in two North American teaching hospitals. All pretreatment scans prospectively scored. The score divides middle-cerebral-artery territory into ten regions interest. Primary outcomes symptomatic intracerebral haemorrhage and 3-month functional outcome. sensitivity specificity ASPECTS for primary calculated. Logistic regression was used to test association between outcomes. Findings Ischaemic changes baseline seen 117 (75%) 156 anteriorcirculation ischaemia included analysis (23 had posterior circulation 24 outside protocol). Baseline value correlated inversely severity National Institutes Health Scale (r=� 0·56, p<0·001). predicted outcome (p<0·001, p=0·012, respectively). 0·78 0·96; values 0·90 0·62. Agreement observers ASPECTS, knowledge affected hemisphere, good (� statistic 0·71–0·89). Interpretation This simple reliable identifies unlikely make an independent recovery despite treatment.