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1 30, 11-16, 2010 Z Z score Computed tomography ROC analysis 3 CT 1,2 CT 1/3 3 5 CT CT 6 7,8 MCA ASPECTS Alberta Stroke Programme Early CT Score 4 10 CT ASPECTS 50% 9 Z 10 CT Z CT 10 Z Z Z receiver operating characteristic : ROC Z CT 2 CT CT CT Emotion mm

12 1. ASPECTS 10 C : I : L : IC : M1 : M2 : M3 : M4 M5 M6 : M1 M2 M3 1 ASPECTS 10 10 C : I : L : IC : M1 : M2 : M3 : M4 M5 M6 : M1 M2 M3 21 2 ASPECTS 10 4 CT MRI CT 21 68 142 3 MRI CT

2 12 1. ASPECTS 10 C : I : L : IC : M1 : M2 : M3 : M4 M5 M6 : M1 M2 M3 1 ASPECTS C : I : L : IC : M1 : M2 : M3 : M4 M5 M6 : M1 M2 M ASPECTS 10 4 CT MRI CT MRI CT CT Z ; 12 3 Z Z - 1 SPM2 Statistical Parametric Mapping 2 11, mm 2 1 CT Z CT CT CT CT Z Z Z CT Z MCA Z 5 CT Z 4 mm CT Z Z Z

3 CT CT ASPECTS 10 CT Z CT Z ASPECTS Z CT 50 Z Z ASPECTS AccuracyAccuracy Z Accuracy Student paired t - test Z ROC ROC ROC ROCKIT 0.9B C. E. Metz, University of Chicago, Ill 13 Z ROC areas under the ROC curves : AUC Jackknife 15 Jackknife LABM- RMC C.E. Metz, University of Chicago, Ill P Accuracy Z 81.2% 85.1% P=0.002 ROC 2 Z AUC P =0.03Z AUC Z

4 14 2. Z - ROC Z ASPECTS ASPECTS 10 AS- PECTS 9 ROC Z Z CT CT CT a CT L C M2 M3 M5 b Z - c MR CT CT CT 6

15 Accuracy Z 81.2% 85.1% ROC AUC Z 0.872 0.917 Z CT 4. 1.

5 15 Accuracy Z 81.2% 85.1% ROC AUC Z Z CT a CT L I b Z - c 2 CT Z 4 Z Adams H et al : Guidelines for the early management of patients with ischemic stroke : 2005 guidelines update a scientific statement from the Stroke Council of the American Heart Association/American Stroke Association. Stroke 36 : , Adams JHP et al : Guidelines for the early management of patients with ischemic stroke : A scientific statement from the Stroke Council of the American Stroke Association. Stroke 34 : , von Kummer R et al : Acute stroke : usefulness of early CT findings before thrombolytic therapy. Radiology 205 : , Balbel PA et al : Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. Lancet 355 : , Kalafut MA et al : Detection of early CT signs of >1/3 middle cerebral artery infarctions : interrater reliability and sensitivity of CT interpretation by physicians involved in acute stroke care. Stroke 31 : , Fiebach JB et al : CT and diffusion - weighted MR imaging in randomized order : diffusion - weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke 33 : , Schriger DL et al : Cranial computed tomography interpretation in acute stroke : physician accuracy in determining eligibility for thrombolytic therapy. JAMA 279 : , 1998

6 16 8Wardlaw JM et al : Early signs of brain infarction at CT : observer reliability and outcome after Thrombolytic treatment - systematic review. Radiology 235 : , Camargo ECS et al : Acute brain infarct : detection and delineation with CT angiographic source images versus nonenhanced CT scans. Radiology 244 : , Takahashi N et al : Z - score mapping method for extracting hypoattenuation areas of hyperacute stroke in unenhanced CT. Acad Radiol 17 : 84-92, Friston KJ et al : Spatial registration and normalization of images. Hum Brain Mapp 3 : , Ashburner J et al : Nonlinear spatial normalization using basis functions. Hum Brain Mapp 7 : , Metz CE et al : Maximum likelihood estimation of receiver operating characteristic ROC curves from continuously - distributed data. Stat Med 17 : , Uozumi T et al : ROC analysis on detection of metastatic pulmonary nodules on digital chest radiographs by use of temporal subtraction. Acad Radiol 8 : , Dorfman DD et al : Receiver operating characteristic rating analysis. Generalization to the population of readers and patients with the jackknife method. Invest Radiol 27 : , 1992

審査報告書（案）

審査報告書（案） 19 83 7 18 628 1 19 8 3 7 18 6 28 30 MI 31 360 21700BZY00247000 5mm CEA 59 mm 2 50% 80 1. 2. 3 19 8 3 [ ] 7 [ ] [ ] [ ] [ ] 18 6 28 [ ] CEA 49mm 50 80 2 4 carotid endarterectomy CEA 1,2 CEA ECST 3 NASCET