Figure 1.
ASPECTS for mismatch assessment in CT perfusion.
C, caudate head; I, insular ribbon; IC, internal capsule; L, lentiform nucleus; M1-M6, MCA region 1–6; CBF, cerebral blood flow; CBV, cerebral blood volume.
Table 1.
Patient characteristics (N = 29).
Table 2.
Inter- and intrareader agreement for quantitative methods of mismatch assessment, depending on perfusion deficit volume of the patient, N = 29.
Table 3.
Favorable Penumbra pattern classification (yes/no) based on volumetry, visual estimation, and ASPECTS, N = 29.
Figure 2.
Whole brain CTP mismatch assessment in a 79 yrs old female who presented with a mild left-sided hemiparesis and facial paresis.
NIHSS on admission was 2. WB-CTP was performed 185 min after symptom onset. Concerning MMASPECTS, all readers rated for both CBF and CBV ASPECTS regions M1 and M4 in the right hemisphere as the only affected ones. Therefore, in none of the four readings, an ASPECTS mismatch was considered present (MMASPECTS = CBFASPECTS - CBVASPECTS = 8 - 8 = 0). However, volumetric assessment revealed an extensive mismatch of 59.9%. MMEST varied from 30 to 80% (mean 57.5±26.3%). ASPECTS, Alberta Stroke Programme Early CT Score; CBF, cerebral blood flow; CBV, cerebral blood volume; NIHSS, National Institutes of Health Stroke Scale.
Table 4.
Visual and ASPECTS penumbra classification in comparison to penumbra classification based on volumetry, N = 29.