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. 2019 Oct 23;9:15243. doi: 10.1038/s41598-019-51708-6

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© The Author(s) 2019

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Illustrative cases of combined interpretation of ASPECTS and CTA-based collaterals in the estimation of infarct core volume. (A) While the ASPECTS score was high, it showed discrepancies with collateral grades. In this patient, MR ADC revealed a large infarct core. (B) This patient showed both a high ASPECTS score and CT collateral grade. MR ADC revealed a small infarct core, illustrating the importance of combined interpretation of ASPECTS and collateral grade. (C) While both ASPECTS and sCTAc grades suggested large infarct cores, mCTAc grade showed favorable pial collaterals. MR ADC revealed an intermediate infarct core. This case illustrated the importance of mCTAc for detecting larger infarct cores. (D) Low ASPECTS score and low collateral score predicted a high infarct core volume, as illustrated. ASPECTS, Alberta stroke program early CT score; CTA, computed tomographic angiography; MR, magnetic resonance; ADC, apparent diffusion coefficient; sCTAc, single-phase CT angiography collateral; mCTAc, multiphase CT angiography collateral.