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ASPECTS Alberta Stroke Program Early CT Score

vigente

A 10 point topographic score of early ischemic change in the middle cerebral artery territory on non-contrast CT.

Índice de referência, não é suporte à decisão clínica. O RadCommons apresenta conteúdo de referência reescrito a partir de critérios publicados e com link para a fonte primária. Confira sempre a publicação primária vigente. Não é um dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.
Escala de categorias
10>=6<6

As figuras e tabelas estão na fonte primária. Abrir a fonte. O RadCommons reescreve e cita, não reproduz figuras protegidas por direitos autorais.

Procedência e vigência

Órgão emissor
Alberta Stroke Program
Versão
2000
Ano
2000
Família
léxico
Tipo de lógica
score
Modalidade
CT
Fonte primária
Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke (ASPECTS) · doi:10.1016/S0140-6736(00)02237-6
Última verificação
2026-07-24
Última checagem
2026-07-24

Lógica de decisão

Forma estruturada (score). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Calculate and report the exact 0-10 score plus involved regions and modality. The legacy RadCommons outcome bands are interpretive outputs; current EVT selection requires the additional variables encoded in EVT_2026_context.

Mostrar a lógica estruturada (JSON)
{
  "applicability": {
    "use_for": "Early ischemic change in the affected middle cerebral artery territory on noncontrast CT in acute anterior-circulation ischemic stroke.",
    "interpret_with": [
      "affected_hemisphere",
      "vessel_occlusion_site",
      "time_from_onset_or_last_known_well",
      "NIHSS",
      "prestroke_mRS",
      "age",
      "mass_effect",
      "other_imaging_and_clinical_criteria"
    ],
    "do_not_substitute": [
      "PC_ASPECTS_for_posterior_circulation",
      "DWI_ASPECTS_without_naming_the_modality",
      "volumetric_core_measurement"
    ]
  },
  "starting_score": 10,
  "operation": "Subtract one point for each defined region with early ischemic change; minimum 0 and maximum 10.",
  "early_ischemic_change": [
    "focal_brain_swelling",
    "parenchymal_hypoattenuation"
  ],
  "feature_groups": [
    {
      "id": "deep_structures",
      "points_each_if_involved": -1,
      "regions": [
        {
          "code": "C",
          "name": "caudate"
        },
        {
          "code": "L",
          "name": "lentiform_nucleus"
        },
        {
          "code": "IC",
          "name": "internal_capsule"
        }
      ]
    },
    {
      "id": "mca_cortical_regions",
      "points_each_if_involved": -1,
      "regions": [
        {
          "code": "I",
          "name": "insular_ribbon"
        },
        {
          "code": "M1",
          "name": "anterior_MCA_cortex_frontal_operculum"
        },
        {
          "code": "M2",
          "name": "MCA_cortex_lateral_to_insular_ribbon_anterior_temporal_lobe"
        },
        {
          "code": "M3",
          "name": "posterior_MCA_cortex_posterior_temporal_lobe"
        },
        {
          "code": "M4",
          "name": "anterior_MCA_territory_immediately_superior_to_M1"
        },
        {
          "code": "M5",
          "name": "lateral_MCA_territory_immediately_superior_to_M2"
        },
        {
          "code": "M6",
          "name": "posterior_MCA_territory_immediately_superior_to_M3"
        }
      ]
    }
  ],
  "levels": {
    "ganglionic": [
      "C",
      "L",
      "IC",
      "I",
      "M1",
      "M2",
      "M3"
    ],
    "supraganglionic": [
      "M4",
      "M5",
      "M6"
    ]
  },
  "score_map": [
    {
      "score": 10,
      "outcome_code": "10",
      "interpretation": "No early ischemic change in the ten assessed MCA regions."
    },
    {
      "score": "6-9",
      "outcome_code": ">=6",
      "interpretation": "Limited regional early ischemic change; legacy RadCommons band excludes the separately represented exact score 10."
    },
    {
      "score": "0-5",
      "outcome_code": "<6",
      "interpretation": "Larger burden of regional early ischemic change; management differs between scores 3-5 and 0-2."
    }
  ],
  "EVT_2026_context": [
    {
      "time_window": "0-6_hours",
      "ASPECTS": "3-10",
      "other_required_features": [
        "anterior_circulation_ICA_or_M1_LVO",
        "NIHSS>=6",
        "prestroke_mRS_0-1"
      ],
      "recommendation": "EVT_recommended"
    },
    {
      "time_window": "6-24_hours",
      "ASPECTS": "6-10",
      "other_required_features": [
        "anterior_circulation_ICA_or_M1_LVO",
        "NIHSS>=6",
        "prestroke_mRS_0-1"
      ],
      "recommendation": "EVT_recommended"
    },
    {
      "time_window": "6-24_hours",
      "ASPECTS": "3-5",
      "other_required_features": [
        "selected_patient",
        "age<80",
        "anterior_circulation_ICA_or_M1_LVO",
        "NIHSS>=6",
        "prestroke_mRS_0-1",
        "no_significant_mass_effect"
      ],
      "recommendation": "EVT_recommended"
    },
    {
      "time_window": "0-6_hours",
      "ASPECTS": "0-2",
      "other_required_features": [
        "selected_patient",
        "age<80",
        "anterior_circulation_ICA_or_M1_LVO",
        "NIHSS>=6",
        "prestroke_mRS_0-1",
        "no_significant_mass_effect"
      ],
      "recommendation": "EVT_reasonable"
    }
  ],
  "safety_rule": "ASPECTS is one imaging input, not a standalone treatment decision. Never deny or mandate reperfusion therapy from the score alone.",
  "source_locator": "Barber et al., Lancet 2000, Methods pp 1671-1672 and Fig 1 for score operation and ten regions; AHA/ASA 2026 AIS Guideline, section 4.7.2 recommendations 1-4 for EVT selection."
}

Categorias num relance

Cat.SignificadoCondutaRiscoFonte
10
Normal scan, no early ischemic change
Exact ASPECTS 10: no early ischemic change in any of the ten assessed regions of the affected middle cerebral artery territory on noncontrast CT. Start at 10 and subtract one point for each involved region: C, L, IC, I, and M1-M6.		ASPECTS 10 alone neither mandates nor excludes reperfusion. For ICA or M1 large-vessel occlusion with NIHSS at least 6 and prestroke mRS 0-1, the 2026 AHA/ASA guideline recommends EVT within 6 hours and from 6-24 hours when the other eligibility criteria are met.This is the least extensive end of the ASPECTS early-ischemic-change scale. Higher baseline scores were associated with better functional outcome and lower symptomatic hemorrhage risk in the original thrombolysis cohort, but the score is not an individual prognosis.
okfonte
Barber et al., Lancet 2000, Methods pp 1671-1672 and Fig 1; AHA/ASA 2026 AIS Guideline section 4.7.2, recommendations 1-2.
>=6
Scores 6-9, limited regional early ischemic change
Legacy RadCommons interpretation band for exact scores 6-9 because exact score 10 is represented separately. Each lost point denotes early ischemic change in one of the ten MCA regions; report the exact numeric score and involved regions rather than the band alone.		ASPECTS at least 6 is only one EVT input. For ICA or M1 occlusion with NIHSS at least 6 and prestroke mRS 0-1, EVT is recommended within 6 hours and from 6-24 hours under the 2026 AHA/ASA guideline; vessel, time, function, examination, and other imaging criteria must also be checked.Scores 6-9 indicate less extensive regional early ischemic change than scores 0-5. Higher ASPECTS is generally associated with more favorable outcomes, but no score supplies a standalone probability or treatment result.
okfonte
Barber et al., Lancet 2000, Methods pp 1671-1672 and Results/Discussion pp 1672-1673; AHA/ASA 2026 AIS Guideline section 4.7.2, recommendations 1-2.
<6
Scores 0-5, larger early ischemic change burden
Exact ASPECTS 0-5, indicating early ischemic change in at least five of the ten assessed MCA regions. This combined legacy band must be split into scores 3-5 versus 0-2 before applying current endovascular-treatment guidance.		Do not use ASPECTS below 6 as an automatic thrombectomy exclusion. In otherwise eligible ICA/M1 occlusion, EVT is recommended for ASPECTS 3-5 within 6 hours; from 6-24 hours it is recommended in selected patients younger than 80 with NIHSS at least 6, prestroke mRS 0-1, and no significant mass effect. For selected ASPECTS 0-2 patients younger than 80 with the same core clinical criteria and no significant mass effect, EVT within 6 hours is reasonable.Lower ASPECTS reflects more extensive early ischemic change and was associated with worse functional outcome and greater symptomatic hemorrhage risk in the original cohort. It is not synonymous with wholly irreversible tissue and is not a standalone futility rule.
okfonte
Barber et al., Lancet 2000, Methods pp 1671-1672 and Discussion p 1673; AHA/ASA 2026 AIS Guideline section 4.7.2, recommendations 1, 3, and 4.

Histórico de versões

DataEventoDetalheSituação
2000-05-13publishedASPECTS validated in the Lancet.confirmado
Quickstart da APIGET /api/v1/systems/aspectsaberto
curl -s "https://radcommons.laudos.ai/api/v1/systems/aspects"
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