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- Title
Perfusion CT in acute stroke: prediction of vessel recanalization and clinical outcome in intravenous thrombolytic therapy.
- Authors
Kloska, Stephan P.; Dittrich, Ralf; Fischer, Tobias; Nabavi, Darius G.; Fischbach, Roman; Seidensticker, Peter; Osada, Nani; Ringelstein, E. Bernd; Heindel, Walter
- Abstract
This study evaluated perfusion computed tomography (PCT) for the prediction of vessel recanalization and clinical outcome in patients undergoing intravenous thrombolysis. Thirty-nine patients with acute ischemic stroke of the middle cerebral artery territory underwent intravenous thrombolysis within 3 h of symptom onset. They all had non-enhanced CT (NECT), PCT, and CT angiography (CTA) before treatment. The Alberta Stroke Program Early Computed Tomography (ASPECT) score was applied to NECT and PCT maps to assess the extent of ischemia. CTA was assessed for the site of vessel occlusion. The National Institute of Health Stroke Scale (NIHSS) score was used for initial clinical assessment. Three-month clinical outcome was assessed using the modified Rankin scale. Vessel recanalization was determined by follow-up ultrasound. Of the PCT maps, a cerebral blood volume (CBV) ASPECT score of >6 versus < or =6 was the best predictor for clinical outcome (odds ratio, 31.43; 95% confidence interval, 3.41-289.58; P < 0.002), and was superior to NIHSS, NECT and CTA. No significant differences in ASPECT scores were found for the prediction of vessel recanalization. ASPECT score applied to PCT maps in acute stroke patients predicts the clinical outcome of intravenous thrombolysis and is superior to both early NECT and clinical parameters.
- Subjects
TOMOGRAPHY; THROMBOLYTIC therapy; MEDICAL radiography; HEART diseases; DRUG therapy; FIBRINOLYTIC agents; CEREBRAL arteries; CEREBRAL ischemia; COMPARATIVE studies; COMPUTED tomography; INTRAVENOUS injections; VASCULAR resistance; RESEARCH methodology; MEDICAL cooperation; RESEARCH; STROKE; EVALUATION research; TREATMENT effectiveness; PREDICTIVE tests; RETROSPECTIVE studies; DISEASE complications
- Publication
European Radiology, 2007, Vol 17, Issue 10, p2491
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-007-0696-9