• Lars-Peder Pallesen, Johannes Gerber, Imanuel Dzialowski, Erik J R J van der Hoeven, Patrik Michel, Thomas Pfefferkorn, Christoph Ozdoba, L Jaap Kappelle, Baerbel Wiedemann, Andrei Khomenko, Ale Algra, Michael D Hill, Ruediger von Kummer, Andrew M Demchuk, Wouter J Schonewille, Volker Puetz, and BASICS Study Group.
• Dresden University Stroke Center, University of Technology Dresden, Dresden, Germany.
• J Neuroimaging. 2015 May 1;25(3):384-9.

Background And PurposeThe 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.MethodsWe 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.ResultsCTA 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).ConclusionCTP 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.Copyright © 2014 by the American Society of Neuroimaging.

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