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Correlation of volumetric mismatch and mismatch of Alberta Stroke Program Early CT Scores on CT perfusion maps

  • Diagnostic Neuroradiology
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Abstract

Introduction

We aimed to determine if volumetric mismatch between tissue at risk and tissue destined to infarct on computed tomography perfusion (CTP) can be described by the mismatch of Alberta Stroke Program Early CT Score (ASPECTS).

Materials and methods

Forty patients with nonlacunar middle cerebral artery infarct <6 h old who had CTP on admission were retrospectively reviewed. Two raters segmented the lesion volume on mean transit time (MTT) and cerebral blood volume (CBV) maps using thresholds of >6 s and <2.0 mL per 100 g, respectively. Two other raters assigned ASPECTS to the same MTT and CBV maps while blinded to the volumetric data. Volumetric mismatch was deemed present if ≥20%. ASPECTS mismatch (=CBV ASPECTS − MTT ASPECTS) was deemed present if ≥1. Correlation between the two types of mismatches was assessed by Spearman’s coefficient (ρ). ROC curve analyses were performed to determine the optimal ASPECTS mismatch cut point for volumetric mismatch ≥20%, ≥50%, ≥100%, and ≥150%.

Results

Median volumetric mismatch was 130% (range 10.9–2,031%) with 31 (77.5%) being ≥20%. Median ASPECTS mismatch was 2 (range 0–6) with 26 (65%) being ≥1. ASPECTS mismatch correlated strongly with volumetric mismatch with ρ = 0.763 [95% CI 0.585–0.870], p < 0.0001. Sensitivity and specificity for volumetric mismatch ≥20% was 83.9% [95% CI 65.5–93.5] and 100% [95% CI 65.9–100], respectively, using ASPECTS mismatch ≥1. Volumetric mismatch ≥50%, ≥100%, and ≥150% were optimally identified using ASPECTS mismatch ≥1, ≥2, and ≥2, respectively.

Conclusion

On CTP, ASPECTS mismatch showed strong correlation to volumetric mismatch. ASPECTS mismatch ≥1 was the optimal cut point for volumetric mismatch ≥20%.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, NYU Medical Center/Bellevue Hospital, 462 First Avenue, NBV 3W39, New York, NY, 10016, USA

    Ke Lin, Otto Rapalino, Benjamin Lee, Kinh G. Do, Amado R. Sussmann & Bidyut K. Pramanik

  2. Department of Radiology, Mount Sinai Medical Center, New York, NY, USA

    Meng Law

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  1. Ke Lin
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  2. Otto Rapalino
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  3. Benjamin Lee
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  4. Kinh G. Do
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  7. Bidyut K. Pramanik
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Correspondence to Ke Lin.

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Lin, K., Rapalino, O., Lee, B. et al. Correlation of volumetric mismatch and mismatch of Alberta Stroke Program Early CT Scores on CT perfusion maps. Neuroradiology 51, 17–23 (2009). https://doi.org/10.1007/s00234-008-0454-y

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  • DOI: https://doi.org/10.1007/s00234-008-0454-y

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