ASPECTS: MCA alanı erken BT skoru

Özet

ASPECTS, akut ön dolaşım inmesinde MCA alanındaki erken parankimal değişikliklerin yerini sistematik biçimde kaydeder. Kontrastsız BT'de iki aksiyel düzeyde on bölge incelenir ve yeni iskemi bulgusu olan her bölge başlangıç puanından düşülür. ASPECTS, MCA bölgesindeki erken iskemi değişikliklerini değerlendirmek amacıyla geliştirilmiş, her bölgedeki değişikliğin bir puan düşürdüğü yarı niceliksel bir topografik skorlama sistemidir. ASPECTS, akut MCA inmesinde kontrastsız BT üzerinde tanımlı 10 bölgenin her birinde erken iskemik değişiklik bulunan her birinden bir puan çıkarılarak hesaplanan, başlangıç değeri 10 olan yarı niceliksel bir skorlama sistemidir.

Faz ve pencere

Kontrastsız tanısal

Bazal gangliyon düzeyinde C, L, IC, I ve M1-M3; lateral ventriküllerin görüldüğü supraganglionik düzeyde M4-M6 bölgelerinde yeni hipodensite, gri-beyaz ayrım kaybı veya sulkus effasmanı aranır. ASPECTS için kontrast gerekmez.

Önerilen pencereler: İnme (G 40 / M 40), Beyin (G 80 / M 40).

BT bulguları

• Kaudat başı (C) — frontal boynuz komşuluğundaki kaudat başında yeni hipodensite olup olmadığı kaydedilir.
• Lentiform çekirdek (L) — putamen ve globus pallidusun gri-beyaz cevher ayrımının korunup korunmadığı ve konturunun belirginliği incelenir.
• İç kapsül (IC) — bazal gangliyon ile talamus arasındaki kompakt beyaz cevher şeridi değerlendirilir.
• İnsula (I) — Sylvian fissür derinindeki insular gri şeridin seçilebilirliği puanlamaya katılır.
• M1-M3 kortikal bölgeleri — bazal gangliyon kesitinde anterior, insulaya komşu lateral ve posterior MCA korteksi gözden geçirilir.
• M4-M6 kortikal bölgeleri — lateral ventrikül gövdesi düzeyinde anterior, lateral ve posterior MCA alanı değerlendirilir.
• Bölgesel puan düşüşü — akut iskemik değişiklik saptanan her tanımlı bölge bir puan kaybettirir; normal bölge puanını korur.

Ölçütler ve sınıflamalar

Başlangıç puanı

10 puan

İncelenen MCA bölgeleri

10 bölge

On bölgeli ASPECTS

C, L, IC, I ve M1-M6 bölgelerinin her biri normal ise bir puan alır; yeni iskemi bulgusu olan her bölgeden bir puan çıkarılır. Toplam başlangıç değeri 10'dur ve skor 0'a kadar düşebilir.

Normalde

Normal referans kesitinde kaudat başı, lentiform çekirdek, internal kapsül ve insular şerit karşı hemisferle simetrik görünür; kortikal sulkuslar da benzer açıklıktadır. Lateral ventrikül düzeyinde M4, M5 ve M6 bölgelerinin gri-beyaz cevher ayrımını karşı hemisferle kıyaslayıp yalnızca yeni ve tek taraflı bulguları puanlayın.

Ayırıcı tanı

Önceden geçirilmiş MCA alanı iskemik lezyonları, akut infarkt bölgelerinin değerlendirilmesinde ayrı tutulmalıdır.

ASPECTS, MCA bölgesindeki kortikal ve subkortikal bölgeleri kapsar; derin laküner kaviter lezyonlar tipik ASPECTS skorlamasının odak noktası değildir.

Bilateral periventriküler beyaz cevher hipodensitesi, ASPECTS'in puanlanan kaudat, internal kapsül, lentiform çekirdek, insular korteks ve M1–M6 bölgeleri arasında tanımlanmamıştır.

Tuzaklar

• Skoru infarkt hacmi gibi sunma; ASPECTS topografik ve yarı nicel bir bölge puanıdır.
• Bazal gangliyon seviyesini ve lateral ventrikül seviyesini karıştırma; M1-M3 ile M4-M6 farklı kesit düzeylerine aittir.
• Kronik enfarkt, eski kanama veya belirgin lökoarayozu yeni iskemi puanı olarak düşme; önce kronik morfolojiyi tanı.
• ASPECTS, her bir bölgedeki değişikliğin bir puan düşürdüğü yarı niceliksel bir topografik sistemdir; toplam skorun yanı sıra hangi bölgelerin etkilendiği de önemlidir.

Kendini dene

1. Kontrastsız BT'de C, I ve M2 bölgelerinde yeni iskemi var; diğer yedi bölge normal. ASPECTS kaçtır?

   • 7
   • 3
   • 10
   • 6
   Cevabı göster

   7. Üç etkilenen bölgenin her biri başlangıçtaki 10 puandan bir puan düşürür; kalan skor 7'dir. Üç etkilenen bölge sayısı skorun kendisi değildir.

2. ASPECTS, akut MCA inmesinde erken iskemik değişiklikleri hangi görüntüleme yöntemiyle değerlendirmek için geliştirilmiştir?

   • MR anjiyografi
   • Kontrastsız BT
   • BT perfüzyon
   • Kontrastlı BT anjiyografi
   Cevabı göster

   Kontrastsız BT. ASPECTS, akut MCA inmesinde erken iskemik değişiklikleri kontrastsız BT üzerinde değerlendirmek için geliştirilmiş bir skorlama sistemidir.

Bu konunun yer aldığı turlar

• İnme BT'si: erken iskemi, damar ve taklitçiler

İlgili konular

• Erken iskemik değişiklikler
• MCA alanı infarktı
• Posterior dolaşım ASPECTS (pc-ASPECTS)

Kaynaklar

Bu sayfadaki 38 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla tek tek karşılaştırıldı; 11 cümle bu karşılaştırmada düzeltildi (2026-10-08).

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