RadEssentialReading-room reference
ASPECTS
10-point topographic score for early ischemic change in the MCA territory on non-contrast CT. Start at 10 and subtract 1 for each region with early ischemic change (hypoattenuation or loss of grey–white differentiation; focal swelling alone is not scored in the original method).
Regions
| Level | Regions |
|---|---|
| Ganglionic | C caudate · L lentiform · IC internal capsule (posterior limb) · I insular ribbon · M1 anterior MCA cortex · M2 MCA cortex lateral to insula · M3 posterior MCA cortex |
| Supraganglionic | M4, M5, M6: anterior, lateral, posterior MCA territory immediately superior to M1, M2, M3 (above the basal ganglia) |
Score it
ASPECTS10
Pearls
- Use two standardized axial levels: the thalamus/basal ganglia level and the level just above the ganglionic structures.
- Score of ≤7 was associated with markedly worse functional outcome and higher symptomatic hemorrhage risk after IV thrombolysis in the original cohort.
- Narrow window (e.g. W 40 / L 40) improves detection of subtle hypoattenuation.
Sources
- Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. Lancet. 2000;355:1670–1674.PubMed ↗
Radessential summarizes published classification systems for practicing radiologists. Summaries are condensed; confirm details against the cited source before relying on them for patient care.