急性基底动脉闭塞性卒中PC-ASPECTS评分与PMT评分的一致性比较  

Comparison of the consistency between PC-ASPECTS score and PMT score in acute basilar artery occlusive stroke

作　　者：柯烨 何野 石冉 王朋[1] KE Ye;HE Ye;SHI Ran;WANG Peng(The First Affiliated Hospital of USTC,Hefei 230001,Anhui)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院),安徽合肥230001

出　　处：《安徽医专学报》2025年第1期28-31,共4页Journal of Anhui Medical College

基　　金：安徽省重点研发计划项目(编号:202104j0702020049)。

摘　　要：目的:评估急性基底动脉闭塞性卒中患者基于头颅磁共振(MRI)的后循环阿尔伯塔卒中计划早期计算机断层扫描评分(PC-ASPECTS)及脑桥中脑-丘脑评分(PMT)等影像学评分的一致性。方法:前瞻性纳入32例急性基底动脉闭塞性卒中患者。由12名临床医师对MRI进行评分,评分数据用于最后的一致性分析,即总体一致性及二分法后的一致性。结果:二分法前,基于MRI的PC-ASPECTS评分与PMT评分的总体组间一致性均达到了良好的水平(κ=0.791[95%CI,0.732-0.843];κ=0.684[95%CI,0.603-0.724])。在二分法后,PC-ASPECTS评分总体医师的组间一致性达到了优秀的水平(κ=0.824[95%CI,0.738-0.912]);而PMT评分的总体医师的组间一致性仍然处于良好的水平(κ=0.769[95%CI,0.693-0.859])。结论:相比于PMT评分,临床医生在评估基于MRI的PCASPECTS评分时,在给予一定的容差范畴的情况下,其一致性的值更高,足以支持可重复的临床决策和评估。Objective:This study was designed to appraise the agreement between the Posterior Circulation Acute Stroke Prognosis Early Computed Tomography Scores(PC-ASPECTS)and the Pons-Midbrain-Thalamus(PMT)scores,as determined by head Magnetic Resonance Imaging(MRI),in patients with acute basilar artery occlusion.Methods:A prospective cohort of 32 patients suffering from acute basilar artery occlusion was enrolled.The head MRI scans were independently scored twice by a panel of 12 clinicians.These scores were subsequently utilized for agreement analysis,encompassing both exact agreement and agreement following dichotomization.Results:Before dichotomization,the exact interrater agreement of MRI-based PC-ASPECTS and PMT reached substantial forκ(0.791[95%CI,0.732-0.843];0.684[95%CI,0.603-0.724]).After dichotomization,the exact interrater agreement of PC-ASPECTS reached excellent forκ(0.824[95%CI,0.738-0.912]),while the exact interrater agreement of PMT scores remained substantial forκ(0.769[95%CI,0.693-0.896]).Conclusion:Based on head MRI,PC-ASPECTS exhibited higher levels of agreement within a specific tolerance range in comparison to PMT,thereby facilitating reproducible clinical decision-making and assessment.

关 键 词：脑卒中 一致性 PC-ASPECTS评分 PMT评分 

分 类 号：R743.3[医药卫生—神经病学与精神病学]