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已发表论文
ASPECTS 与 CTP 核心梗死体积在接受血管内治疗的急性缺血性卒中患者中的比较预后价值
Authors Wang Z, Zhang L, Wang X, Yu X, Tang J, Dai X, Qiu T
Received 19 November 2025
Accepted for publication 2 April 2026
Published 21 April 2026 Volume 2026:19 582848
DOI https://doi.org/10.2147/IJGM.S582848
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Redoy Ranjan
Zezhao Wang,1,2,* Liyuan Zhang,1,2,* Xi Wang,2,3 Xueji Yu,2 Jie Tang,2 Xiaoyan Dai,4 Tao Qiu2
1Department of Neurology,The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, People’s Republic of China; 2Department of Neurology, Zigong First People’s Hospital, Zigong, Sichuan, 643000, People’s Republic of China; 3Department of Neurology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China; 4Outpatient Department, Zigong First People’s Hospital, Zigong, Sichuan, 643000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Tao Qiu, Department of Neurology, Zigong First People’s Hospital, No. 42, Shangyihao 1st Branch Road, Ziliujing District, Zigong, Sichuan, 643000, People’s Republic of China, Email qiutao_zgyyy@163.com Xiaoyan Dai, Outpatient Department, Zigong First People’s Hospital, No. 42, Shangyihao 1st Branch Road, Ziliujing District, Zigong, Sichuan, 643000, People’s Republic of China, Email dxy_zgyyy@163.com
Background: Rapid and accurate imaging assessment is critical for selecting acute ischemic stroke (AIS) patients for endovascular therapy. While CT perfusion (CTP) provides quantitative evaluation of infarct core, the ASPECTS score based on non-contrast CT (NCCT) is widely used for its speed and simplicity. However, their comparative predictive value and consistency in clinical practice remain unclear.
Objective: To evaluate the prognostic value of NCCT-based ASPECTS and CTP-derived core infarct volume in AIS patients undergoing endovascular treatment, and to explore their correlation and clinical implications.
Methods: In this retrospective single-center study, we analyzed 82 patients with acute ischemic stroke who underwent endovascular therapy within 24 hours of symptom onset. Preoperative ASPECTS scores and CTP-defined core infarct volumes (processed via Shukun software) were recorded. Prognostic outcome was defined by the 90-day modified Rankin Scale (mRS). Statistical analysis included logistic regression, ROC curve analysis, and Spearman correlation.
Results: Patients with poor outcomes had significantly larger CTP-derived infarct core volumes and lower ASPECTS scores (both P< 0.001). In the overall cohort, CTP (AUC=0.74) and ASPECTS (adjusted AUC=0.71) demonstrated comparable predictive performance, with no statistically significant difference. In subgroup analyses stratified by onset-to-treatment time, both modalities remained predictive, and no significant differences in predictive accuracy were observed between ASPECTS and CTP in either the ≤ 6-hour or 6– 24-hour groups. A moderate negative correlation was observed between ASPECTS and core infarct volume (r=– 0.61, P< 0.001).
Conclusion: Both ASPECTS and CTP-derived core infarct volume predict functional outcomes in AIS patients undergoing endovascular therapy, with comparable performance. ASPECTS offers a rapid assessment, whereas CTP provides quantitative evaluation. The two modalities may serve complementary roles in clinical decision-making.
Keywords: ASPECTS, CT perfusion, acute ischemic stroke, endovascular therapy, prognosis
1Department of Neurology,The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, People’s Republic of China; 2Department of Neurology, Zigong First People’s Hospital, Zigong, Sichuan, 643000, People’s Republic of China; 3Department of Neurology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China; 4Outpatient Department, Zigong First People’s Hospital, Zigong, Sichuan, 643000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Tao Qiu, Department of Neurology, Zigong First People’s Hospital, No. 42, Shangyihao 1st Branch Road, Ziliujing District, Zigong, Sichuan, 643000, People’s Republic of China, Email qiutao_zgyyy@163.com Xiaoyan Dai, Outpatient Department, Zigong First People’s Hospital, No. 42, Shangyihao 1st Branch Road, Ziliujing District, Zigong, Sichuan, 643000, People’s Republic of China, Email dxy_zgyyy@163.com
Background: Rapid and accurate imaging assessment is critical for selecting acute ischemic stroke (AIS) patients for endovascular therapy. While CT perfusion (CTP) provides quantitative evaluation of infarct core, the ASPECTS score based on non-contrast CT (NCCT) is widely used for its speed and simplicity. However, their comparative predictive value and consistency in clinical practice remain unclear.
Objective: To evaluate the prognostic value of NCCT-based ASPECTS and CTP-derived core infarct volume in AIS patients undergoing endovascular treatment, and to explore their correlation and clinical implications.
Methods: In this retrospective single-center study, we analyzed 82 patients with acute ischemic stroke who underwent endovascular therapy within 24 hours of symptom onset. Preoperative ASPECTS scores and CTP-defined core infarct volumes (processed via Shukun software) were recorded. Prognostic outcome was defined by the 90-day modified Rankin Scale (mRS). Statistical analysis included logistic regression, ROC curve analysis, and Spearman correlation.
Results: Patients with poor outcomes had significantly larger CTP-derived infarct core volumes and lower ASPECTS scores (both P< 0.001). In the overall cohort, CTP (AUC=0.74) and ASPECTS (adjusted AUC=0.71) demonstrated comparable predictive performance, with no statistically significant difference. In subgroup analyses stratified by onset-to-treatment time, both modalities remained predictive, and no significant differences in predictive accuracy were observed between ASPECTS and CTP in either the ≤ 6-hour or 6– 24-hour groups. A moderate negative correlation was observed between ASPECTS and core infarct volume (r=– 0.61, P< 0.001).
Conclusion: Both ASPECTS and CTP-derived core infarct volume predict functional outcomes in AIS patients undergoing endovascular therapy, with comparable performance. ASPECTS offers a rapid assessment, whereas CTP provides quantitative evaluation. The two modalities may serve complementary roles in clinical decision-making.
Keywords: ASPECTS, CT perfusion, acute ischemic stroke, endovascular therapy, prognosis