Perfusion CT: Additional Diagnostic and Clinical Information in MCA Stroke

Lopes, L.
December 2010
Neuroradiology Journal;Dec2010, Vol. 23 Issue 6, p651
Academic Journal
With multidetector computed tomography equipment it is possible to identify early signs of ischemia on non-enhanced CT (NECT) and have access to cerebral hemodynamics using perfusion CT (PCT). Based on specific patterns of hemodynamic changes of cerebral blood flow, cerebral blood volume and mean transit time it is feasible to create probability maps of brain tissue and calculate de potential recuperation ratio. The difference between irreversible and reversible brain damage or "tissue at risk" is essential for choosing an appropriate therapy. We evaluated the sensitivity of NECT and PCT in the diagnosis of middle cerebral artery (MCA) ischemic stroke, established their correlation with the clinical evaluation and analysed their changes in time. Thirty patients with MCA ischemic stroke underwent NECT and PCT in the acute T1 (M=7,0 h; min-0,50; max=24), subacute T2 (M=5,0 d; min=2,0, max=14,0) and chronic phase T3 (M=39,1 d; min=28,0; max=61,0). Clinical assessment and outcome were rated using the modified National Institute of Health Stroke Scale (mNIHSS). In the diagnosis of MCA stroke, PCT was more sensitive (83%) than NECT (70%). On admission, compared MTT values (r=0,560) and cerebral ischemic volume (CIV) (r=0,486) correlated with the clinical severity. Initial NECT changes correlated with the clinical evolution in T2 (r=-0,403) and T3 (r=-0,363). The PRR decreased over time, but it demonstrated a large variation for the same time period. The association of NECT with PCT can yield an early stroke diagnosis. It may possibly predict clinical severity and outcome. In addition, this association could provide an insight into the extent of penumbra and quantify the PRR, which is of paramount importance in therapeutic decision-making.


Related Articles

  • Ischemic stroke. Severity of leukoaraiosis, leptomeningeal collaterals, and clinical outcomes after intra-arterial therapy in patients with acute ischemic stroke. Fitzpatrick, Kaitlin; Schwamm, Lee H.; Rost, Natalia S.; Giurgiutiu, Dan-Victor; Leslie-Mazwi, Thabele; Yoo, Albert J.; Chaudhry, Zeshan // Journal of NeuroInterventional Surgery;May2015, Vol. 7 Issue 5, p326 

    Background and purpose Leukoaraiosis (LA) is defined as ischemic white matter lesions associated with increased stroke risk and poor post-stroke outcomes. These lesions are likely the result of diffuse angiopathic changes affecting the cerebral small vessels. We investigated whether pre-existing...

  • Ischemic stroke. Picture-to-puncture time in acute stroke endovascular intervention: are we getting faster? van Heerden, J; Yan, B; Churilov, L; Dowling, R J; Mitchell, P J // Journal of NeuroInterventional Surgery;Aug2015, Vol. 7 Issue 8, p564 

    Background In acute stroke management, time efficiency in the continuum of patient management is critical. We aimed to determine if implementation of system improvements at our institution translated to reduced picture-to-puncture (P2P) times over a 6-year period. Methods We conducted a...

  • Endovascular treatment for M2 occlusions in the era of stentrievers: a descriptive multicenter experience. Flores, Alan; Tomasello, Alejandro; Cardona, Pere; de Miquel, M. Angeles; Gomis, Meritxell; Bermejo, Pablo Garcia; Obach, Victor; Urra, Xabi; Martí-Fàbregas, Joan; Cánovas, David; Roquer, Jaume; Abilleira, Sònia; Ribó, Marc // Journal of NeuroInterventional Surgery;Apr2015, Vol. 7 Issue 4, p234 

    Background Patients with M2 middle cerebral artery (MCA) occlusions are not always considered for endovascular treatment. Objective To study outcomes in patients with M2 occlusion treated with endovascular procedures in the era of stentrievers. Methods We studied patients prospectively...

  • Relationship of Neutrophil–Lymphocyte Ratio With the Presence, Severity, and Extent of Coronary Atherosclerosis Detected by Coronary Computed Tomography Angiography. Açar, Göksel; Fidan, Serdar; Uslu, Zulal Alnur; Turkday, Sevim; Avci, Anıl; Alizade, Elnur; Kalkan, Mehmet Emin; Tabakci, Omer Naci; Tanboğa, Ibrahim Halil; Esen, Ali Metin // Angiology;Feb2015, Vol. 66 Issue 2, p174 

    We evaluated whether the neutrophil–lymphocyte ratio (NLR) was associated with the presence, severity, and extent of coronary atherosclerotic plaques detected by computed tomography angiography (CTA). We studied 238 patients who underwent dual-source 64-slice CTA for the assessment of...

  • The Impact of Mild Stroke on Participation in Physical Fitness Activities. Hildebrand, Mary; Brewer, Megan; Wolf, Timothy // Stroke Research & Treatment;2012, p1 

    Objective. To compare participation in moderate to high intensity physical activities in persons before and after a mild stroke. Methods. We used data from the Cognitive Rehabilitation and Research Group to examine changes in moderate to high intensity physical activity participation in persons...

  • Ischemic stroke. Disposition to home or acute rehabilitation is associated with a favorable clinical outcome in the SENTIS trial. Belagaje, Samir R.; Zander, Kay; Thackeray, Lisa; Gupta, Rishi // Journal of NeuroInterventional Surgery;May2015, Vol. 7 Issue 5, p322 

    Objective To explore the impact of stroke severity and discharge disposition on 90-day outcomes in US patients enrolled in the SENTIS trial. Methods SENTIS is a previously published prospective randomized controlled trial. We analyzed the demographic information, National Institutes of Health...

  • A significant risk factor for poststroke depression: the depression-related subnetwork. Songran Yang; Ping Hua; Xinyuan Shang; Zaixu Cui; Suyu Zhong; Gaolang Gong; Humphreys, Glyn W. // Journal of Psychiatry & Neuroscience;Jul2015, Vol. 40 Issue 4, p259 

    Background: Despite being one of the direct causes of depression, whether stroke-induced neuroanatomical deterioration actually plays an important role in the onset of poststroke depression (PSD) is controversial. We assessed the structural basis of PSD, particularly with regard to white matter...

  • Validation of the use of the ROSIER scale in prehospital assessment of stroke. He Mingfeng; Wu Zhixin; Guo Qihong; Li Lianda; Yang Yanbin; Feng Jinfang // Annals of Indian Academy of Neurology;Sep2012, Vol. 15 Issue 3, p191 

    Aim: To determine the utility of the Recognition of Stroke in the Emergency Room (ROSIER) scale as a stroke recognition tool among Chinese patients in the prehospital setting. Materials and Methods: Compared with the Cincinnati Prehospital Stroke Scale (CPSS), emergency physicians prospectively...

  • Presence of anterior temporal artery associates with good outcome in acute atherosclerotic M1-middle cerebral artery occlusion. Liu, Dezhi; Li, Yongkun; Shi, Zhaorong; Davis, Stephen; Wong, Ka; Leung, Thomas; Yan, Bernard; Xiong, Yunyun; Sun, Wen; Xu, Gelin; Zhang, Renliang; Liu, Xinfeng // Neuroradiology;Dec2014, Vol. 56 Issue 12, p1023 

    Introduction: We aim to investigate the correlation between presence of anterior temporal artery (ATA), the first major branch of middle cerebral artery (MCA), on conventional angiography and clinical outcome in patients with acute atherosclerotic M1-MCA occlusion. Methods: Consecutive patients...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics