Back to Search
Start Over
The role of automated computed topography perfusion in prediction of hemorrhagic transformation after acute ischemic stroke.
- Source :
-
The neuroradiology journal [Neuroradiol J] 2023 Apr; Vol. 36 (2), pp. 182-188. Date of Electronic Publication: 2022 Jul 18. - Publication Year :
- 2023
-
Abstract
- Introduction: The role of computed tomography perfusion (CTP) in prediction of hemorrhagic transformation (HT) has been evolving. We aimed to study the role of automated perfusion post-processing software in prediction of HT using the commercially available RAPID software.<br />Methods: Two hundred eighty-two patients with anterior circulation ischemic stroke, who underwent CTP with RAPID automated post-processing, were retrospectively enrolled and divided into HT ( n = 91) and non-HT groups ( n = 191). The automated RAPID-generated perfusion maps were reviewed. Mismatch volume and ratio, time to maximum (Tmax) > 4-10s volumes, hypoperfusion index, cerebral blood flow (CBF) < 20-38% volumes, cerebral blood volume (CBV) < 34%-42% volumes, and CBV index were recorded and analyzed.<br />Results: The volumes of brain tissues suffering from reduction of cerebral blood flow (CBF < 20%-38%), reduction in cerebral blood volumes (CBV < 34-42%), and delayed contrast arrival times (Tmax > 4-10s) were significantly higher in the HT group. The mismatch volumes were also higher in the HT group ( p = .001). Among these parameters, the Tmax > 6s volume was the most reliable and sensitive predictor of HT ( p = .001, AUC = 0.667). However, the combination of the perfusion parameters can slightly improve the diagnostic efficiency (AUC = 0.703). There was no statistically significant difference between the non-HT group and either the parenchymal or the symptomatic subtypes.<br />Conclusion: The RAPID automated CTP parameters can provide a reliable predictor of HT overall but not the parenchymal or the symptomatic subtypes. The infarct area involving the penumbra and core represented by the Tmax > 6s threshold is the most sensitive predictor; however, the combination of the perfusion parameters can slightly improve the diagnostic efficiency.
Details
- Language :
- English
- ISSN :
- 2385-1996
- Volume :
- 36
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The neuroradiology journal
- Publication Type :
- Academic Journal
- Accession number :
- 35850570
- Full Text :
- https://doi.org/10.1177/19714009221111084