Key result
NCCT ASPECTS appears inferior to DWI MRI or perfusion CT for hyperacute stroke assessment.
There is mounting evidence that shows how poorly non-contrast computed tomography (NCCT) Alberta Stroke Program Early CT Score (ASPECTS) performs in the first three-hours after stroke onset compared to Diffusion weighted (DWI) magnetic resonance imaging (MRI). It is time to move into the 21st century and use more advanced imaging routinely in hyper-acute stroke assessment. While a useful tool if one is limited to NCCT alone, ASPECTS becomes somewhat superfluous as we now have rapid, validated, automated infarct core and penumbra volumes with either MRI or perfusion CT.
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Bivard et al. (2012) conducted an editorial in Hyper-acute stroke. Non-contrast computed tomography (NCCT) ASPECTS vs. Diffusion weighted (DWI) magnetic resonance imaging (MRI) or perfusion CT was evaluated. Non-contrast computed tomography (NCCT) ASPECTS is argued to be inferior to advanced imaging with DWI MRI or perfusion CT for hyper-acute stroke assessment within three hours of onset.
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