title: Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study.
abstract: OBJECTIVE
  The posterior circulation Acute Stroke Prognosis Early CT Score (pc-APECTS) applied to CT angiography source images (CTA-SI) predicts the functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS). We assessed the diagnostic and prognostic impact of pc-ASPECTS applied to perfusion CT (CTP) in the BASICS registry population.
  
  
  METHODS
  We applied pc-ASPECTS to CTA-SI and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) parameter maps of BASICS patients with CTA and CTP studies performed. Hypoattenuation on CTA-SI, relative reduction in CBV or CBF, or relative increase in MTT were rated as abnormal.
  
  
  RESULTS
  CTA and CTP were available in 27/592 BASICS patients (4.6%). The proportion of patients with any perfusion abnormality was highest for MTT (93%; 95% confidence interval [CI], 76%-99%), compared with 78% (58%-91%) for CTA-SI and CBF, and 46% (27%-67%) for CBV (P < .001). All 3 patients with a CBV pc-ASPECTS < 8 compared to 6/23 patients with a CBV pc-ASPECTS ≥ 8 had died at 1 month (RR 3.8; 95% CI, 1.9-7.6).
  
  
  CONCLUSIONS
  CTP was performed in a minority of the BASICS registry population. Perfusion disturbances in the posterior circulation were most pronounced on MTT parameter maps. CBV pc-ASPECTS < 8 may indicate patients with high case fatality.
authors.affiliation: Dresden University Stroke Center, University of Technology Dresden, Dresden, Germany.
authors.forename: Lars-Peder
authors.initials: LP
authors.lastname: Pallesen
authors.forename: Johannes
authors.initials: J
authors.lastname: Gerber
authors.forename: Imanuel
authors.initials: I
authors.lastname: Dzialowski
authors.forename: Erik J R J
authors.initials: EJ
authors.lastname: van der Hoeven
authors.forename: Patrik
authors.initials: P
authors.lastname: Michel
authors.forename: Thomas
authors.initials: T
authors.lastname: Pfefferkorn
authors.forename: Christoph
authors.initials: C
authors.lastname: Ozdoba
authors.forename: L Jaap
authors.initials: LJ
authors.lastname: Kappelle
authors.forename: Baerbel
authors.initials: B
authors.lastname: Wiedemann
authors.forename: Andrei
authors.initials: A
authors.lastname: Khomenko
authors.forename: Ale
authors.initials: A
authors.lastname: Algra
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hill
authors.forename: Ruediger
authors.initials: R
authors.lastname: von Kummer
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Demchuk
authors.forename: Wouter J
authors.initials: WJ
authors.lastname: Schonewille
authors.forename: Volker
authors.initials: V
authors.lastname: Puetz
mesh_terms: D017677:Age Distribution; D000368:Aged; D020520:Brain Infarction / Q000000981:diagnostic imaging* / Q000401:mortality*; D002533:Cerebral Angiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012042:Registries; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014715:Vertebrobasilar Insufficiency
keywords: CT perfusion; basilar artery occlusion; pc-ASPECTS