BACKGROUND AND PURPOSE: To determine whether perfusion computed tomography (PCT) adds value to noncontrast head CT (NCT), CT angiogram (CTA), and clinical assessment in patients suspected of acute ischemic stroke. METHODS: We retrospectively reviewed 165 patients with acute ischemic stroke. PCT was used to calculate the volumes of infarct core and ischemic penumbra on admission. Other imaging data included Alberta Score Program Early CT Score, site of occlusion, and collateral flow. Clinical data included age, time, National Institutes of Health Stroke Scale at baseline, treatment type, and modified Rankin score (mRS) at 90 days. Recanalization status was assessed on follow-up imaging. In a first multivariate regression analysis, we assessed whether volumes of PCT penumbra and infarct core could be predicted from clinical variables, NCT, or CTA, or whether they represented independent information. In a second multivariate regression analysis, we used mRS at 90 days as outcome and determined which variables predicted it best. RESULTS: Of 165 patients identified, 76 had a mRS score of 0 to 2 at 90 days, 89 had a mRS score >2. PCT infarct could be predicted by clinical data, NCT, CTA, and combinations of this data (P<0.05). PCT penumbra could not be predicted by clinical data, NCT, and CTA. All of the variables but NCT and CTA were significantly associated with 90-day mRS outcome. The single most important predictor was recanalization status (P<0.001). PCT penumbra volume (P=0.001) was also a predictor of clinical outcome, especially when considered in conjunction with recanalization through an interaction term (P<0.001). CONCLUSIONS: PCT penumbra represents independent information, which cannot be predicted by clinical, NCT, and CTA data. PCT penumbra is an important determinant of clinical outcome and adds relevant clinical information compared with a stroke CT workup, including NCT and CTA.
BACKGROUND AND PURPOSE: To determine whether perfusion computed tomography (PCT) adds value to noncontrast head CT (NCT), CT angiogram (CTA), and clinical assessment in patients suspected of acute ischemic stroke. METHODS: We retrospectively reviewed 165 patients with acute ischemic stroke. PCT was used to calculate the volumes of infarct core and ischemic penumbra on admission. Other imaging data included Alberta Score Program Early CT Score, site of occlusion, and collateral flow. Clinical data included age, time, National Institutes of Health Stroke Scale at baseline, treatment type, and modified Rankin score (mRS) at 90 days. Recanalization status was assessed on follow-up imaging. In a first multivariate regression analysis, we assessed whether volumes of PCT penumbra and infarct core could be predicted from clinical variables, NCT, or CTA, or whether they represented independent information. In a second multivariate regression analysis, we used mRS at 90 days as outcome and determined which variables predicted it best. RESULTS: Of 165 patients identified, 76 had a mRS score of 0 to 2 at 90 days, 89 had a mRS score >2. PCT infarct could be predicted by clinical data, NCT, CTA, and combinations of this data (P<0.05). PCT penumbra could not be predicted by clinical data, NCT, and CTA. All of the variables but NCT and CTA were significantly associated with 90-day mRS outcome. The single most important predictor was recanalization status (P<0.001). PCT penumbra volume (P=0.001) was also a predictor of clinical outcome, especially when considered in conjunction with recanalization through an interaction term (P<0.001). CONCLUSIONS: PCT penumbra represents independent information, which cannot be predicted by clinical, NCT, and CTA data. PCT penumbra is an important determinant of clinical outcome and adds relevant clinical information compared with a stroke CT workup, including NCT and CTA.
Authors: Clinton D Morgan; Marcus Stephens; Scott L Zuckerman; Magarya S Waitara; Peter J Morone; Michael C Dewan; J Mocco Journal: Interv Neuroradiol Date: 2015-06-10 Impact factor: 1.610
Authors: E M Fanou; J Knight; R I Aviv; S-P Hojjat; S P Symons; L Zhang; M Wintermark Journal: AJNR Am J Neuroradiol Date: 2015-10-15 Impact factor: 3.825
Authors: Fahmi Fahmi; Henk A Marquering; Jordi Borst; Geert J Streekstra; Ludo F M Beenen; Joris M Niesten; Birgitta K Velthuis; Charles B L Majoie; Ed vanBavel Journal: Neuroradiology Date: 2014-04-09 Impact factor: 2.804
Authors: Nerses Sanossian; Katherine A Fu; David S Liebeskind; Sidney Starkman; Scott Hamilton; J Pablo Villablanca; Adrian M Burgos; Robin Conwit; Jeffrey L Saver Journal: J Neuroimaging Date: 2016-06-14 Impact factor: 2.486
Authors: Won Hyung A Ryu; Michael B Avery; Navjit Dharampal; Isabel E Allen; Steven W Hetts Journal: J Neurointerv Surg Date: 2016-11-09 Impact factor: 5.836
Authors: A Rentzos; C Lundqvist; J-E Karlsson; V Vilmarsson; K Schnabel; G Wikholm Journal: AJNR Am J Neuroradiol Date: 2014-06-19 Impact factor: 3.825