Atlas-Based Topographical Scoring for Magnetic Resonance Imaging of Acute Stroke

作者:Kosior Robert K; Lauzon M Louis; Steffenhagen Nikolai; Kosior Jayme C; Demchuk Andrew; Frayne Richard*
来源:Stroke, 2010, 41(3): 455-460.
DOI:10.1161/STROKEAHA.109.567289

摘要

Background and Purpose-The Alberta Stroke Program Early CT Score (ASPECTS), a 10-point scale, is a clinical tool for assessment of early ischemic changes after stroke based on the location and extent of a visible stroke lesion. It has been extended for use with MR diffusion-weighted imaging. The purpose of this work was to automate a MR topographical score (MR-TS) using a digital atlas to develop an objective tool for large-scale analyses and possibly reduce interrater variability and slice orientation differences.
Methods-We assessed 30 patients with acute ischemic stroke with a diffusion lesion who provided informed consent. Patients were imaged by CT and MRI within 24 hours of symptom onset. An MR-TS digital atlas was generated using the ASPECTS scoring sheet and anatomic MR data sets. Automated MR topographical scores (auto-MR-TS) were obtained based on the overlap of lesions on apparent diffusion coefficient maps with MR-TS atlas regions. Auto-MR-TS scores were then compared with scores derived manually (man-MR-TS) and with conventional CT ASPECTS scores.
Results-Of the 30 patients, 29 were assessed with auto-MR-TS. Auto-MR-TS was significantly lower than CT ASPECTS (P < 0.001), but with a median difference of only 1 point. There was no significant difference between the auto-MR-TS and the man-MR-TS with a median difference of 0 points; 86% of patient scores differed by <= 1 point.
Conclusion-Auto-MR-TS provides a measure of stroke severity in an automated fashion and facilitates more objective, sensitive, and potentially more complex ASPECTS-based scoring. (Stroke. 2010;41:455-460.)

  • 出版日期2010-3