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Article: Hypodensity of >1/3 middle cerebral artery territory versus Alberta Sroke Programme Early CT Score (ASPECTS): Comparison of two methods of quantitative evaluation of early CT changes in hyperacute ischemic stroke in the community setting

TitleHypodensity of >1/3 middle cerebral artery territory versus Alberta Sroke Programme Early CT Score (ASPECTS): Comparison of two methods of quantitative evaluation of early CT changes in hyperacute ischemic stroke in the community setting
Authors
Issue Date2003
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://stroke.ahajournals.org
Citation
Stroke, 2003, v. 34 n. 5, p. 1194-1196 How to Cite?
AbstractBackground - The one third middle cerebral artery territory (1/3 MCA) method and the Alberta Stroke Program Early CT Score (ASPECTS) were used to detect significant early ischemic changes (EIC) on CT brain of acute stroke patients. We sought to compare the reliability of the 2 methods in routine clinical practice. Methods - Eighty consecutive patients admitted to a community hospital in Hong Kong with suspected acute ischemic stroke and a CT brain scan performed within 6 hours of symptom onset were included. Five blinded observers (1 neurologist, 2 general radiologists, and 2 neuroradiologists) independently evaluated the scans, using the ATLANTIS/CT Summit criteria for >1/3 MCA involvement, and ASPECTS ≤7. Kappa statistics were used to determine interobserver agreement. Results - Significant EIC were present in 11.4% of the scans with the 1/3 MCA method, and 19.4% with ASPECTS. For >1/3 MCA involvement, all observers agreed in 57 cases (71%), with moderate interobserver agreement (κ = 0.49). For ASPECTS ≤7, all observers agreed in 34 cases (42%), with fair interobserver agreement (κ = 0.34). After prevalence and bias adjustments, substantial (prevalence-adjusted bias-adjusted κ [PABAK] = 0.74) and moderate (PABAK = 0.44) agreements were found for the 1/3 MCA method and ASPECTS respectively. Conclusions - The 1/3 MCA method was more reliable in detecting significant EIC on CT brain within 6 hours of stroke onset in routine clinical practice, whereas ASPECTS was able to detect significant EIC in a higher proportion of these early scans.
Persistent Identifierhttp://hdl.handle.net/10722/150878
ISSN
2015 Impact Factor: 5.787
2015 SCImago Journal Rankings: 3.671
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMak, HKFen_US
dc.contributor.authorYau, KKWen_US
dc.contributor.authorKhong, PLen_US
dc.contributor.authorChing, ASCen_US
dc.contributor.authorCheng, PWen_US
dc.contributor.authorAuYeung, PKMen_US
dc.contributor.authorPang, PKMen_US
dc.contributor.authorWong, KCWen_US
dc.contributor.authorChan, BPLen_US
dc.date.accessioned2012-06-26T06:13:39Z-
dc.date.available2012-06-26T06:13:39Z-
dc.date.issued2003en_US
dc.identifier.citationStroke, 2003, v. 34 n. 5, p. 1194-1196en_US
dc.identifier.issn0039-2499en_US
dc.identifier.urihttp://hdl.handle.net/10722/150878-
dc.description.abstractBackground - The one third middle cerebral artery territory (1/3 MCA) method and the Alberta Stroke Program Early CT Score (ASPECTS) were used to detect significant early ischemic changes (EIC) on CT brain of acute stroke patients. We sought to compare the reliability of the 2 methods in routine clinical practice. Methods - Eighty consecutive patients admitted to a community hospital in Hong Kong with suspected acute ischemic stroke and a CT brain scan performed within 6 hours of symptom onset were included. Five blinded observers (1 neurologist, 2 general radiologists, and 2 neuroradiologists) independently evaluated the scans, using the ATLANTIS/CT Summit criteria for >1/3 MCA involvement, and ASPECTS ≤7. Kappa statistics were used to determine interobserver agreement. Results - Significant EIC were present in 11.4% of the scans with the 1/3 MCA method, and 19.4% with ASPECTS. For >1/3 MCA involvement, all observers agreed in 57 cases (71%), with moderate interobserver agreement (κ = 0.49). For ASPECTS ≤7, all observers agreed in 34 cases (42%), with fair interobserver agreement (κ = 0.34). After prevalence and bias adjustments, substantial (prevalence-adjusted bias-adjusted κ [PABAK] = 0.74) and moderate (PABAK = 0.44) agreements were found for the 1/3 MCA method and ASPECTS respectively. Conclusions - The 1/3 MCA method was more reliable in detecting significant EIC on CT brain within 6 hours of stroke onset in routine clinical practice, whereas ASPECTS was able to detect significant EIC in a higher proportion of these early scans.en_US
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://stroke.ahajournals.orgen_US
dc.relation.ispartofStrokeen_US
dc.subject.meshAcute Diseaseen_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshBrain Ischemia - Drug Therapy - Epidemiology - Radiographyen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshInfarction, Middle Cerebral Artery - Drug Therapy - Epidemiology - Radiographyen_US
dc.subject.meshIschemic Attack, Transient - Drug Therapy - Epidemiology - Radiographyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshObserver Variationen_US
dc.subject.meshPredictive Value Of Testsen_US
dc.subject.meshPrevalenceen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshReproducibility Of Resultsen_US
dc.subject.meshSeverity Of Illness Indexen_US
dc.subject.meshSingle-Blind Methoden_US
dc.subject.meshThrombolytic Therapyen_US
dc.subject.meshTime Factorsen_US
dc.titleHypodensity of >1/3 middle cerebral artery territory versus Alberta Sroke Programme Early CT Score (ASPECTS): Comparison of two methods of quantitative evaluation of early CT changes in hyperacute ischemic stroke in the community settingen_US
dc.typeArticleen_US
dc.identifier.emailMak, HKF:makkf@hkucc.hku.hken_US
dc.identifier.emailKhong, PL:plkhong@hkucc.hku.hken_US
dc.identifier.authorityMak, HKF=rp00533en_US
dc.identifier.authorityKhong, PL=rp00467en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1161/01.STR.0000069162.64966.71en_US
dc.identifier.pmid12690213-
dc.identifier.scopuseid_2-s2.0-0037629001en_US
dc.identifier.hkuros81015-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0037629001&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume34en_US
dc.identifier.issue5en_US
dc.identifier.spage1194en_US
dc.identifier.epage1196en_US
dc.identifier.isiWOS:000182586100018-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridMak, HKF=7004699149en_US
dc.identifier.scopusauthoridYau, KKW=7101941425en_US
dc.identifier.scopusauthoridKhong, PL=7006693233en_US
dc.identifier.scopusauthoridChing, ASC=7005773485en_US
dc.identifier.scopusauthoridCheng, PW=7401618753en_US
dc.identifier.scopusauthoridAuYeung, PKM=6602956911en_US
dc.identifier.scopusauthoridPang, PKM=7102589845en_US
dc.identifier.scopusauthoridWong, KCW=7404758629en_US
dc.identifier.scopusauthoridChan, BPL=7201530762en_US

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