BACKGROUND/ PURPOSE: Perfusion computed tomography (CT) is capable of measuring the permeability surface product (PS). PS reflects the permeability of the blood-brain barrier, involved in the pathophysiology of hemorrhagic transformation (HT) of ischemic stroke. The aim of our study was to determine if an increased PS can predict HT. METHODS: A total of 86 patients with ischemic stroke were included. They underwent multimodality CT, including the measurement of PS. We compared the clinical and radiological characteristics of patients who developed HT to those who did not, using univariate analysis. Multivariate regression analyses were then used to determine HT predictors. RESULTS: HT was observed in 27 patients (31%). Infarct PS was significantly associated with HT (p = 0.047), as were atrial fibrillation (p = 0.03), admission National Institute of Health Stroke Scale score (p = 0.02), infarct volume (p = 0.0004), presence of large-vessel occlusion (p = 0.0005) and a poorer collateral status (p = 0.003). Using logistic regression modeling, an infarct PS >0.84 ml/100 g/min was an independent predictor of HT (OR 28, 95% CI 1.75-452.98; p = 0.02). Other independent predictors of HT were infarct volume and a history of atrial fibrillation. CONCLUSIONS: Our findings suggest that infarct PS can be a predictor of HT and may help clinicians to improve patient care around thrombolysis decisions in the acute phase of ischemic stroke.
BACKGROUND/ PURPOSE: Perfusion computed tomography (CT) is capable of measuring the permeability surface product (PS). PS reflects the permeability of the blood-brain barrier, involved in the pathophysiology of hemorrhagic transformation (HT) of ischemic stroke. The aim of our study was to determine if an increased PS can predict HT. METHODS: A total of 86 patients with ischemic stroke were included. They underwent multimodality CT, including the measurement of PS. We compared the clinical and radiological characteristics of patients who developed HT to those who did not, using univariate analysis. Multivariate regression analyses were then used to determine HT predictors. RESULTS:HT was observed in 27 patients (31%). Infarct PS was significantly associated with HT (p = 0.047), as were atrial fibrillation (p = 0.03), admission National Institute of Health Stroke Scale score (p = 0.02), infarct volume (p = 0.0004), presence of large-vessel occlusion (p = 0.0005) and a poorer collateral status (p = 0.003). Using logistic regression modeling, an infarct PS >0.84 ml/100 g/min was an independent predictor of HT (OR 28, 95% CI 1.75-452.98; p = 0.02). Other independent predictors of HT were infarct volume and a history of atrial fibrillation. CONCLUSIONS: Our findings suggest that infarct PS can be a predictor of HT and may help clinicians to improve patient care around thrombolysis decisions in the acute phase of ischemic stroke.
Authors: Alexander D Horsch; Edwin Bennink; Tom van Seeters; L Jaap Kappelle; Yolanda van der Graaf; Willem P T M Mali; Hugo W A M de Jong; Birgitta K Velthuis; Jan Willem Dankbaar Journal: Cerebrovasc Dis Date: 2018-01-08 Impact factor: 2.762
Authors: J Ivanidze; O N Kallas; A Gupta; E Weidman; H Baradaran; D Mir; A Giambrone; A Z Segal; J Claassen; P C Sanelli Journal: AJNR Am J Neuroradiol Date: 2016-04-28 Impact factor: 3.825
Authors: Josep Puig; Gerard Blasco; Pepus Daunis-I-Estadella; Cecile van Eendendburg; María Carrillo-García; Carlos Aboud; María Hernández-Pérez; Joaquín Serena; Carles Biarnés; Kambiz Nael; David S Liebeskind; Götz Thomalla; Bijoy K Menon; Andrew Demchuk; Max Wintermark; Salvador Pedraza; Mar Castellanos Journal: PLoS One Date: 2017-11-28 Impact factor: 3.240