Qiao Li1, Xinyi Gao1, Zhenwei Yao1, Xiaoyuan Feng1, Huijin He2, Jing Xue1, Peiyi Gao1, Lumeng Yang1, Xin Cheng1, Weijian Chen1, Yunjun Yang1. 1. From the Departments of Radiology (Q.L., X.G., Z.Y., X.F., H.H.) and Neurology (L.Y., X.C.), Huashan Hospital, Fudan University, Shanghai, China; Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.X., P.G.); Department of Radiology, The First Affiliated Hospital, Wenzhou Medical University, China (W.C., Y.Y.). 2. From the Departments of Radiology (Q.L., X.G., Z.Y., X.F., H.H.) and Neurology (L.Y., X.C.), Huashan Hospital, Fudan University, Shanghai, China; Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.X., P.G.); Department of Radiology, The First Affiliated Hospital, Wenzhou Medical University, China (W.C., Y.Y.). hehuijin@hotmail.com cjr.gaopeiyi@vip.163.com.
Abstract
BACKGROUND AND PURPOSE: Permeability surface (PS) on computed tomographic perfusion reflects blood-brain barrier permeability and is related to hemorrhagic transformation (HT). HT of deep middle cerebral artery (MCA) territory can occur after recanalization of proximal large-vessel occlusion. We aimed to determine the relationship between HT and PS of deep MCA territory. METHODS: We retrospectively reviewed 70 consecutive acute ischemic stroke patients presenting with occlusion of the distal internal carotid artery or M1 segment of the MCA. All patients underwent computed tomographic perfusion within 6 hours after symptom onset. Computed tomographic perfusion data were postprocessed to generate maps of different perfusion parameters. Risk factors were identified for increased deep MCA territory PS. Receiver operating characteristic curve analysis was performed to calculate the optimal PS threshold to predict HT of deep MCA territory. RESULTS: Increased PS was associated with HT of deep MCA territory. After adjustments for age, sex, onset time to computed tomographic perfusion, and baseline National Institutes of Health Stroke Scale, poor collateral status (odds ratio, 7.8; 95% confidence interval, 1.67-37.14; P=0.009) and proximal MCA-M1 occlusion (odds ratio, 4.12; 95% confidence interval, 1.03-16.52; P=0.045) were independently associated with increased deep MCA territory PS. Relative PS most accurately predicted HT of deep MCA territory (area under curve, 0.94; optimal threshold, 2.89). CONCLUSIONS: Increased PS can predict HT of deep MCA territory after recanalization therapy for cerebral proximal large-vessel occlusion. Proximal MCA-M1 complete occlusion and distal internal carotid artery occlusion in conjunction with poor collaterals elevate deep MCA territory PS.
BACKGROUND AND PURPOSE: Permeability surface (PS) on computed tomographic perfusion reflects blood-brain barrier permeability and is related to hemorrhagic transformation (HT). HT of deep middle cerebral artery (MCA) territory can occur after recanalization of proximal large-vessel occlusion. We aimed to determine the relationship between HT and PS of deep MCA territory. METHODS: We retrospectively reviewed 70 consecutive acute ischemic strokepatients presenting with occlusion of the distal internal carotid artery or M1 segment of the MCA. All patients underwent computed tomographic perfusion within 6 hours after symptom onset. Computed tomographic perfusion data were postprocessed to generate maps of different perfusion parameters. Risk factors were identified for increased deep MCA territory PS. Receiver operating characteristic curve analysis was performed to calculate the optimal PS threshold to predict HT of deep MCA territory. RESULTS: Increased PS was associated with HT of deep MCA territory. After adjustments for age, sex, onset time to computed tomographic perfusion, and baseline National Institutes of Health Stroke Scale, poor collateral status (odds ratio, 7.8; 95% confidence interval, 1.67-37.14; P=0.009) and proximal MCA-M1 occlusion (odds ratio, 4.12; 95% confidence interval, 1.03-16.52; P=0.045) were independently associated with increased deep MCA territory PS. Relative PS most accurately predicted HT of deep MCA territory (area under curve, 0.94; optimal threshold, 2.89). CONCLUSIONS: Increased PS can predict HT of deep MCA territory after recanalization therapy for cerebral proximal large-vessel occlusion. Proximal MCA-M1 complete occlusion and distal internal carotid artery occlusion in conjunction with poor collaterals elevate deep MCA territory PS.
Authors: Matt Heyck; Brooke Bonsack; Henry Zhang; Nadia Sadanandan; Blaise Cozene; Chase Kingsbury; Jea-Young Lee; Cesar V Borlongan Journal: Exp Biol Med (Maywood) Date: 2019-10-11
Authors: Sara Bernardo-Castro; João André Sousa; Ana Brás; Carla Cecília; Bruno Rodrigues; Luciano Almendra; Cristina Machado; Gustavo Santo; Fernando Silva; Lino Ferreira; Isabel Santana; João Sargento-Freitas Journal: Front Neurol Date: 2020-12-09 Impact factor: 4.003