Perfusion computed tomography: Prediction of final infarct extent and stroke outcome
The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) has not been previously applied to perfusion CT (CTP). Five raters assigned ASPECTS to baseline noncontrast CT (NCCT), CT angiography source images (CTA‐SI), CTP source images (CTP‐SI), and CTP maps of cerebral blood volume (CBV),...
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| Veröffentlicht in: | Annals of neurology 2005-11, Vol.58 (5), p.672-679 |
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| container_title | Annals of neurology |
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| creator | Parsons, Mark W. Pepper, Elizabeth M. Chan, Virgil Siddique, Sabbir Rajaratnam, Siva Bateman, Grant A. Levi, Christopher R. |
| description | The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) has not been previously applied to perfusion CT (CTP). Five raters assigned ASPECTS to baseline noncontrast CT (NCCT), CT angiography source images (CTA‐SI), CTP source images (CTP‐SI), and CTP maps of cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) from 37 consecutive patients with less than 6‐hour anterior circulation ischemic stroke. Major reperfusion was identified on follow‐up imaging. Mean baseline ASPECTS was compared with follow‐up imaging ASPECTS. Rates of favorable outcome were compared for dichotomized baseline ASPECTS. In patients with major reperfusion, mean CBV and CTP‐SI ASPECTS closely predicted final infarct ASPECTS. In patients without major reperfusion, mean CBF and MTT ASPECTS best predicted final infarct ASPECTS. There were significant increases in rates of favorable outcome for CTP‐SI and CBV ASPECTS of greater than 6, versus less than or equal to 6, but not for other baseline CT modalities. ASPECTS applied to CTP is more accurate at identifying the extent of reversible and irreversible ischemia and at predicting final clinical outcome than NCCTor CTA‐SI. Ann Neurol 2005;58:672–679 |
| doi_str_mv | 10.1002/ana.20638 |
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Five raters assigned ASPECTS to baseline noncontrast CT (NCCT), CT angiography source images (CTA‐SI), CTP source images (CTP‐SI), and CTP maps of cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) from 37 consecutive patients with less than 6‐hour anterior circulation ischemic stroke. Major reperfusion was identified on follow‐up imaging. Mean baseline ASPECTS was compared with follow‐up imaging ASPECTS. Rates of favorable outcome were compared for dichotomized baseline ASPECTS. In patients with major reperfusion, mean CBV and CTP‐SI ASPECTS closely predicted final infarct ASPECTS. In patients without major reperfusion, mean CBF and MTT ASPECTS best predicted final infarct ASPECTS. There were significant increases in rates of favorable outcome for CTP‐SI and CBV ASPECTS of greater than 6, versus less than or equal to 6, but not for other baseline CT modalities. ASPECTS applied to CTP is more accurate at identifying the extent of reversible and irreversible ischemia and at predicting final clinical outcome than NCCTor CTA‐SI. 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Five raters assigned ASPECTS to baseline noncontrast CT (NCCT), CT angiography source images (CTA‐SI), CTP source images (CTP‐SI), and CTP maps of cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) from 37 consecutive patients with less than 6‐hour anterior circulation ischemic stroke. Major reperfusion was identified on follow‐up imaging. Mean baseline ASPECTS was compared with follow‐up imaging ASPECTS. Rates of favorable outcome were compared for dichotomized baseline ASPECTS. In patients with major reperfusion, mean CBV and CTP‐SI ASPECTS closely predicted final infarct ASPECTS. In patients without major reperfusion, mean CBF and MTT ASPECTS best predicted final infarct ASPECTS. There were significant increases in rates of favorable outcome for CTP‐SI and CBV ASPECTS of greater than 6, versus less than or equal to 6, but not for other baseline CT modalities. ASPECTS applied to CTP is more accurate at identifying the extent of reversible and irreversible ischemia and at predicting final clinical outcome than NCCTor CTA‐SI. Ann Neurol 2005;58:672–679</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity - physiology</subject><subject>Brain - diagnostic imaging</subject><subject>Brain - pathology</subject><subject>Brain Infarction - diagnosis</subject><subject>Brain Infarction - diagnostic imaging</subject><subject>Brain Infarction - etiology</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>False Positive Reactions</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Image Processing, Computer-Assisted - methods</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nervous system</subject><subject>Neurology</subject><subject>Outcome Assessment (Health Care)</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Radionuclide investigations</subject><subject>Stroke - complications</subject><subject>Stroke - diagnosis</subject><subject>Stroke - diagnostic imaging</subject><subject>Stroke - physiopathology</subject><subject>Tomography, X-Ray Computed</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0364-5134</issn><issn>1531-8249</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0E1v1DAQBmALUdGlcOAPoFxA4pB2bCf-4LaqYEFatUUqAvViTRwHTJN4azui--9J2aU9VZzmMM-8I72EvKJwTAHYCY54zEBw9YQsaM1pqViln5IFcFGVNeXVIXme0i8A0ILCM3JIBauAc70glxcudlPyYSxsGDZTdm2RwxB-RNz83L4vLqJrvc13-9AVnR-xL_zYYbS5cLfZjbnAsS1SjuHaFWHKc4p7QQ467JN7uZ9H5OvHD5enn8r1-erz6XJd2kopVaIGZoGjbEA3GqiorBRMaQnYCNQa2qZWouUV62zDJXUcgWumLGcNMiv5EXm7y93EcDO5lM3gk3V9j6MLUzJCyYrXEv4Lqda8rkDP8N0O2hhSiq4zm-gHjFtDwdx1beauzd-uZ_t6Hzo1g2sf5L7cGbzZA0wW-y7iaH16cJIroIzO7mTnfvvebR__aJZny3-vy92FT9nd3l9gvDZCclmbb2crs_p-BfUXdmXW_A_6V6Ph</recordid><startdate>200511</startdate><enddate>200511</enddate><creator>Parsons, Mark W.</creator><creator>Pepper, Elizabeth M.</creator><creator>Chan, Virgil</creator><creator>Siddique, Sabbir</creator><creator>Rajaratnam, Siva</creator><creator>Bateman, Grant A.</creator><creator>Levi, Christopher R.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Willey-Liss</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>200511</creationdate><title>Perfusion computed tomography: Prediction of final infarct extent and stroke outcome</title><author>Parsons, Mark W. ; Pepper, Elizabeth M. ; Chan, Virgil ; Siddique, Sabbir ; Rajaratnam, Siva ; Bateman, Grant A. ; Levi, Christopher R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4888-a902c03a7b09b90164c7628970ab6a990db586d342fcb371e3a03928c32ba2c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity - physiology</topic><topic>Brain - diagnostic imaging</topic><topic>Brain - pathology</topic><topic>Brain Infarction - diagnosis</topic><topic>Brain Infarction - diagnostic imaging</topic><topic>Brain Infarction - etiology</topic><topic>Cerebrovascular Circulation - physiology</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>False Positive Reactions</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Image Processing, Computer-Assisted - methods</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Magnetic Resonance Angiography</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nervous system</topic><topic>Neurology</topic><topic>Outcome Assessment (Health Care)</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Radionuclide investigations</topic><topic>Stroke - complications</topic><topic>Stroke - diagnosis</topic><topic>Stroke - diagnostic imaging</topic><topic>Stroke - physiopathology</topic><topic>Tomography, X-Ray Computed</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Parsons, Mark W.</creatorcontrib><creatorcontrib>Pepper, Elizabeth M.</creatorcontrib><creatorcontrib>Chan, Virgil</creatorcontrib><creatorcontrib>Siddique, Sabbir</creatorcontrib><creatorcontrib>Rajaratnam, Siva</creatorcontrib><creatorcontrib>Bateman, Grant A.</creatorcontrib><creatorcontrib>Levi, Christopher R.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Parsons, Mark W.</au><au>Pepper, Elizabeth M.</au><au>Chan, Virgil</au><au>Siddique, Sabbir</au><au>Rajaratnam, Siva</au><au>Bateman, Grant A.</au><au>Levi, Christopher R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perfusion computed tomography: Prediction of final infarct extent and stroke outcome</atitle><jtitle>Annals of neurology</jtitle><addtitle>Ann Neurol</addtitle><date>2005-11</date><risdate>2005</risdate><volume>58</volume><issue>5</issue><spage>672</spage><epage>679</epage><pages>672-679</pages><issn>0364-5134</issn><eissn>1531-8249</eissn><coden>ANNED3</coden><abstract>The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) has not been previously applied to perfusion CT (CTP). Five raters assigned ASPECTS to baseline noncontrast CT (NCCT), CT angiography source images (CTA‐SI), CTP source images (CTP‐SI), and CTP maps of cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) from 37 consecutive patients with less than 6‐hour anterior circulation ischemic stroke. Major reperfusion was identified on follow‐up imaging. Mean baseline ASPECTS was compared with follow‐up imaging ASPECTS. Rates of favorable outcome were compared for dichotomized baseline ASPECTS. In patients with major reperfusion, mean CBV and CTP‐SI ASPECTS closely predicted final infarct ASPECTS. In patients without major reperfusion, mean CBF and MTT ASPECTS best predicted final infarct ASPECTS. There were significant increases in rates of favorable outcome for CTP‐SI and CBV ASPECTS of greater than 6, versus less than or equal to 6, but not for other baseline CT modalities. ASPECTS applied to CTP is more accurate at identifying the extent of reversible and irreversible ischemia and at predicting final clinical outcome than NCCTor CTA‐SI. Ann Neurol 2005;58:672–679</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>16240339</pmid><doi>10.1002/ana.20638</doi><tpages>8</tpages></addata></record> |
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| ispartof | Annals of neurology, 2005-11, Vol.58 (5), p.672-679 |
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| subjects | Aged Aged, 80 and over Biological and medical sciences Blood Flow Velocity - physiology Brain - diagnostic imaging Brain - pathology Brain Infarction - diagnosis Brain Infarction - diagnostic imaging Brain Infarction - etiology Cerebrovascular Circulation - physiology Diffusion Magnetic Resonance Imaging False Positive Reactions Female Follow-Up Studies Humans Image Processing, Computer-Assisted - methods Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Angiography Male Medical sciences Nervous system Neurology Outcome Assessment (Health Care) Predictive Value of Tests Prospective Studies Radionuclide investigations Stroke - complications Stroke - diagnosis Stroke - diagnostic imaging Stroke - physiopathology Tomography, X-Ray Computed Vascular diseases and vascular malformations of the nervous system |
| title | Perfusion computed tomography: Prediction of final infarct extent and stroke outcome |
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