• Henry K F Mak, Kelvin K W Yau, Pek-Lan Khong, Alex S C Ching, Pui-Wai Cheng, Paul K M Au-Yeung, Peter K M Pang, Kenny C W Wong, Bernard P L Chan, and Alberta Stroke Programme Early CT Score.
• Department of Diagnostic Radiology, Yan Chai Hospital, Tsuen Wan, Hong Kong Special Administrative Region, China. kfmakhk@netvigator.com
• Stroke. 2003 May 1;34(5):1194-6.

BackgroundThe 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.MethodsEighty 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 ResultsSignificant 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 (kappa=0.49). For ASPECTS ConclusionsThe (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.

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