ArticlePloS one2013
Reliability of visual assessment of non-contrast CT, CT angiography source images and CT perfusion in patients with suspected ischemic stroke.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 42 citations in OpenAlex.
- Trial
- Observer reliability of CT angiography in the assessment of acute ischaemic stroke: data from the Third International Stroke Trial.Neuroradiology · 2015Trial
- Posterior fossa hematoma: CT perfusion as a tool to reveal occult intracranial hypertension and support surgical decision-making - a case report.BMC neurology · 2026Article
- Prevalence of chameleons in patients with ischemic stroke: A cross-sectional study.Surgical neurology international · 2026Article
- Deep learning derived automated ASPECTS on non-contrast CT scans of acute ischemic stroke patients.Human brain mapping · 2022Article
- Recent Advances in Nanomaterials for Diagnosis, Treatments, and Neurorestoration in Ischemic Stroke.Frontiers in cellular neuroscience · 2022Review
- Endovascular treatment for anterior circulation large-vessel occlusion ischemic stroke with low ASPECTS: a systematic review and meta-analysis.Therapeutic advances in neurological disorders · 2022Article
- Are We Ready to Offer Endovascular Thrombectomy to All Patients With Large Ischemic Core?Frontiers in neurology · 2022Article
- Identifying perfusion deficits on CT perfusion images using temporal similarity perfusion (TSP) mapping.European radiology · 2019Article
- Accuracy of advanced CT imaging in prediction of functional outcome after endovascular treatment in patients with large-vessel occlusion.The neuroradiology journal · 2019Article
- Wake-Up Stroke versus Stroke with Known Onset Time: Clinical and Multimodality CT Imaging Characteristics.Cerebrovascular diseases (Basel, Switzerland) · 2018Observational
- Computed Tomography Perfusion Derived Blood-Brain Barrier Permeability Does Not Yet Improve Prediction of Hemorrhagic Transformation.Cerebrovascular diseases (Basel, Switzerland) · 2018Article
- Visibility of CT Early Ischemic Change Is Significantly Associated with Time from Stroke Onset to Baseline Scan beyond the First 3 Hours of Stroke Onset.Journal of stroke · 2017Article
- Computed Tomography Perfusion Alberta Stroke Program Early Computed Tomography Score Is Associated with Hemorrhagic Transformation after Acute Cardioembolic Stroke.Frontiers in neurology · 2017Article
- Computed tomography perfusion and computed tomography angiography for prediction of clinical outcomes in ischemic stroke patients after thrombolysis.Neural regeneration research · 2017Article
- Performance of CT ASPECTS and Collateral Score in Risk Stratification: Can Target Perfusion Profiles Be Predicted without Perfusion Imaging?AJNR. American journal of neuroradiology · 2016Article
- Imaging Findings Associated with Space-Occupying Edema in Patients with Large Middle Cerebral Artery Infarcts.AJNR. American journal of neuroradiology · 2016Article
- CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circulation stroke.Neuroradiology · 2016Observational
- A Critical Review of Alberta Stroke Program Early CT Score for Evaluation of Acute Stroke Imaging.Frontiers in neurology · 2016Review
- Relation between reperfusion and hemorrhagic transformation in acute ischemic stroke.Neuroradiology · 2015Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeGood reliability of methods to assess the extent of ischemia in acute stroke is important for implementation in clinical practice, especially between observers with varying experience. Our aim was to determine inter- and intra-observer reliability of the 1/3 middle cerebral artery (MCA) rule and the Alberta Stroke Program Early CT Score (ASPECTS) for different CT modalities in patients suspected of acute ischemic stroke.
methodsWe prospectively included 105 patients with acute neurological deficit due to suspected acute ischemic stroke within 9 hours after symptom onset. All patients underwent non-contrast CT, CT perfusion and CT angiography on admission. All images were evaluated twice for presence of ischemia, ischemia with >1/3 MCA involvement, and ASPECTS. Four observers evaluated twenty scans twice for intra-observer agreement. We used kappa statistics and intraclass correlation coefficient to calculate agreement.
resultsInter-observer agreement for the 1/3 MCA rule and ASPECTS was fair to good for non-contrast CT, poor to good for CT angiography source images, but excellent for all CT perfusion maps (cerebral blood volume, mean transit time, and predicted penumbra and infarct maps). Intra-observer agreement for the 1/3 MCA rule and ASPECTS was poor to good for non-contrast CT, fair to moderate for CT angiography source images, and good to excellent for all CT perfusion maps.
conclusionBetween observers with a different level of experience, agreement on the radiological diagnosis of cerebral ischemia is much better for CT perfusion than for non-contrast CT and CT angiography source images, and therefore CT perfusion is a very reliable addition to standard stroke imaging.
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