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 1 1.1 21 1 3 CT 2 CT 21 14 7 66.5 46 92 CT 21 1.86 0.67 3 CT Emotion 16 4.8 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 CT 18 21 1 3.2 0 9 1.2 Z - 10 5 ; 12 3 Z - 4 5 Z - 1 SPM2 Statistical Parametric Mapping 2 11,12 3 79 95 69 2 mm 2 1 CT 10 28 3Z CT CT CT CT Z Z 1 3 4 Z CT Z MCA Z 5 CT Z 4 mm CT Z Z Z
13 1.3 4 9 31 2 4 10 0-100 13 14 CT CT ASPECTS 10 CT Z CT Z ASPECTS 2 8 21 210 Z 100 0 50 100 CT 50 Z 4 1.4 Z ASPECTS AccuracyAccuracy 1 10 50 50 50 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 0.05 2 4 Accuracy Z 81.2% 85.1% P=0.002 ROC 2 Z AUC 0.872 0.917 P =0.03Z AUC 3 3 21 Z
14 2. Z - ROC Z ASPECTS ASPECTS 10 AS- PECTS 9 ROC Z Z CT CT CT 3. 3 62 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. 1.3 92 a CT L I b Z - c 2 CT Z 4 Z 3 18 21 4 1Adams 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 : 916-923, 2005 2Adams 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 : 1056-1083, 2003 3von Kummer R et al : Acute stroke : usefulness of early CT findings before thrombolytic therapy. Radiology 205 : 327-333, 1997 4Balbel PA et al : Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. Lancet 355 : 1670-1674, 2000 5Kalafut 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 : 1667-1671, 2000 6Fiebach 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 : 2144-2155, 2003 7Schriger DL et al : Cranial computed tomography interpretation in acute stroke : physician accuracy in determining eligibility for thrombolytic therapy. JAMA 279 : 1293-1297, 1998
16 8Wardlaw JM et al : Early signs of brain infarction at CT : observer reliability and outcome after Thrombolytic treatment - systematic review. Radiology 235 : 444-453, 2005 9Camargo ECS et al : Acute brain infarct : detection and delineation with CT angiographic source images versus nonenhanced CT scans. Radiology 244 : 541-548, 2007 10Takahashi N et al : Z - score mapping method for extracting hypoattenuation areas of hyperacute stroke in unenhanced CT. Acad Radiol 17 : 84-92, 2010 11Friston KJ et al : Spatial registration and normalization of images. Hum Brain Mapp 3 : 165-189, 1995 12Ashburner J et al : Nonlinear spatial normalization using basis functions. Hum Brain Mapp 7 : 254-266, 1999 13Metz CE et al : Maximum likelihood estimation of receiver operating characteristic ROC curves from continuously - distributed data. Stat Med 17 : 1033-1053, 1998 14Uozumi T et al : ROC analysis on detection of metastatic pulmonary nodules on digital chest radiographs by use of temporal subtraction. Acad Radiol 8 : 871-878, 2001 15Dorfman DD et al : Receiver operating characteristic rating analysis. Generalization to the population of readers and patients with the jackknife method. Invest Radiol 27 : 723-731, 1992