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Infarct-core CT perfusion parameters in predicting post-thrombolysis hemorrhagic transformation of acute ischemic stroke

Crt Langel

Crt Langel

Novo Mesto General HospitalNovo Mesto, Slovenia
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Langel, Crt
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Katarina Surlan Popovic

Katarina Surlan Popovic

Institute of Radiology, University Medical Centre LjubljanaLjubljana, Slovenia
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Popovic, Katarina Surlan
  
Dec 20, 2018
Infarct-core CT perfusion parameters in predicting post-thrombolysis hemorrhagic transformation of acute ischemic stroke's Cover Image
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Article Category: Research Article
Published Online: Dec 20, 2018
Page range: 25 - 30
Received: Aug 26, 2018
Accepted: Nov 11, 2018
DOI: https://doi.org/10.2478/raon-2018-0048
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© 2019 Crt Langel, Katarina Surlan Popovic, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

CT perfusion (CTP) in a 64-year old patient with acute ischemic stroke (AIS) in the territory supplied by the right middle cerebral artery (MCA). Four radiological slices correspond to different anatomical levels of image acquisition. (A) Hand-drawn region of interest (ROI) in the region of infarct core. (B) Automatically generated ROI of the asymptomatic contralateral hemisphere.
CT perfusion (CTP) in a 64-year old patient with acute ischemic stroke (AIS) in the territory supplied by the right middle cerebral artery (MCA). Four radiological slices correspond to different anatomical levels of image acquisition. (A) Hand-drawn region of interest (ROI) in the region of infarct core. (B) Automatically generated ROI of the asymptomatic contralateral hemisphere.

Figure 2

CT perfusion (CTP) in a 64-year old patient with acute ischemic stroke (AIS) in the territory supplied by the right middle cerebral artery (MCA). (A) Infarct core. (B) Penumbra. (C) Intact brain parenchyma.
CT perfusion (CTP) in a 64-year old patient with acute ischemic stroke (AIS) in the territory supplied by the right middle cerebral artery (MCA). (A) Infarct core. (B) Penumbra. (C) Intact brain parenchyma.

Figure 3

Region of interest (ROI) curve of relative cerebral blood flow (rCBF) in patients with and without hemorrhagic transformation (HT). rCBF represents the CBF of the infarct core region normalized to the intact contralateral side. The cut-off point marks the threshold at which relative cerebral blood volume (rCBV) can predict HT with optimal sensitivity and specificity. Diagonal segments are produced by ties.
Region of interest (ROI) curve of relative cerebral blood flow (rCBF) in patients with and without hemorrhagic transformation (HT). rCBF represents the CBF of the infarct core region normalized to the intact contralateral side. The cut-off point marks the threshold at which relative cerebral blood volume (rCBV) can predict HT with optimal sensitivity and specificity. Diagonal segments are produced by ties.

Region of interest (ROI) curve analysis results

AUC cut-off value sensitivity specificity
CBF [mL/100 g/min] 0.691 0.35 62.0% 35.0%
CBV [mL/100g] 0.676 1.65 68.6% 40.0%
rCBF 0.736 4.5% 71.0% 52.5%
rCBV 0.704 8.5% 71.4% 42.5%

Characteristics of study cohort

Parameter Cases Controls p value
CBF (mean (SD)) [mL/100 g/min] 0.38 (0.47) 0.98 (1.37) 0.004
CBV (mean (SD)) [mL/100 g] 1.45 (1.7) 3.06 (2.99) 0.009
MTT (mean (SD)) [s] 4.27 (4.00) 4.22 (3.26) 0.718
rCBF (mean (SD)) 0.03 (0.05) 0.10 (0.12) < 0.000
rCBV (mean (SD)) 0.07 (0.09) 0.10 (0.12) 0.001
rMTT (mean (SD)) 2.47 (2.05) 2.36 (1.65) 0.948
Language:
English
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Journal Subjects:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
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