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Derivation and evaluation of thresholds for core and tissue at risk of infarction using CT perfusion.
- Source :
-
Journal of neuroimaging : official journal of the American Society of Neuroimaging [J Neuroimaging] 2014 Nov-Dec; Vol. 24 (6), pp. 562-568. Date of Electronic Publication: 2014 Jul 04. - Publication Year :
- 2014
-
Abstract
- Background and Purpose: Computed tomography perfusion provides information on tissue viability according to proposed thresholds. We evaluated thresholds for ischemic core and tissue at risk and subsequently tested their accuracy in independent datasets.<br />Materials and Methods: Tissue at risk was evaluated in patients with persistent arterial occlusions, and ischemic core thresholds in patients with recanalization and major clinical improvement. Scans were randomly allocated to derivation or validation groups for tissue at risk and core analysis. Optimum thresholds using mean transit time (MTT), cerebral blood flow (CBF), cerebral blood volume, and delay time (DT) were assessed.<br />Results: Absolute MTT, relative MTT and DT were best derived predictors of tissue at risk with thresholds of ≥ 7 seconds, ≥ 125%, and ≥ 2 seconds respectively. DT ≥ 2 seconds was the best predictor in the validation dataset (95% agreement levels = -44 to +30 mL, Bias = -6.9). Absolute and relative MTT were the best derived predictors of infarct volume in the core group (8 seconds and 125% respectively) but relative CBF of ≤ 45% performed best in the core validation dataset.<br />Conclusions: Time-based perfusion thresholds perform well as predictors of tissue at risk of infarction with DT the best predictor. Relative CBF was the best predictor of ischemic core. Evaluation in larger populations is needed to confirm the performance of tissue viability thresholds.<br /> (Copyright © 2014 by the American Society of Neuroimaging.)
- Subjects :
- Aged
Female
Humans
Male
Reproducibility of Results
Risk Assessment methods
Scotland
Sensitivity and Specificity
Blood Flow Velocity
Cerebral Angiography methods
Cerebral Infarction diagnostic imaging
Cerebral Infarction physiopathology
Cerebrovascular Circulation
Magnetic Resonance Angiography methods
Tomography, X-Ray Computed methods
Subjects
Details
- Language :
- English
- ISSN :
- 1552-6569
- Volume :
- 24
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of neuroimaging : official journal of the American Society of Neuroimaging
- Publication Type :
- Academic Journal
- Accession number :
- 25039499
- Full Text :
- https://doi.org/10.1111/jon.12134