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Study of correlations between CT properties of retrieved cerebral thrombi with treatment outcome of stroke patients

Rebeka Viltuznik
Rebeka Viltuznik
, 
Jernej Vidmar
Jernej Vidmar
, 
Andrej Fabjan
Andrej Fabjan
, 
Miran Jeromel
Miran Jeromel
, 
Zoran V. Milosevic
Zoran V. Milosevic
, 
Igor J. Kocijancic
Igor J. Kocijancic
 y 
Igor Sersa
Igor Sersa
   | 27 sept 2021
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Article Category: Research Article
Publicado en línea: 27 sept 2021
Páginas: 409 - 417
Recibido: 30 nov 2020
Aceptado: 02 sept 2021
DOI: https://doi.org/10.2478/raon-2021-0037
© 2021 Rebeka Viltuznik, Jernej Vidmar, Andrej Fabjan, Miran Jeromel, Zoran V. Milosevic, Igor J. Kocijancic, Igor Sersa, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Light microscopy images of histological slices along representative retrieved cerebral thrombi. The histological slices were stained by hematoxylin-eosin and then analyzed for the RBS proportion. It can be seen from the images that the structural and compositional diversity among cerebral thrombi is high. All retrieved thrombi had a distinctly heterogeneous, laminated (multilayer) structure which involves the interweaving of compacted erythrocyte-rich (red) regions with thinner (pink) coatings containing a combination of complementary-linked platelets and a fibrin network.
Light microscopy images of histological slices along representative retrieved cerebral thrombi. The histological slices were stained by hematoxylin-eosin and then analyzed for the RBS proportion. It can be seen from the images that the structural and compositional diversity among cerebral thrombi is high. All retrieved thrombi had a distinctly heterogeneous, laminated (multilayer) structure which involves the interweaving of compacted erythrocyte-rich (red) regions with thinner (pink) coatings containing a combination of complementary-linked platelets and a fibrin network.

Figure 2

CT image of a patient with stroke (A). In the selected slice, Middle Cerebral Artery (MCA) on both hemispheres of the brain is visible. The occluded MCA section on the right hemisphere and its symmetrical normal MCA section is indicated by a yellow line along the cerebral thrombus. Graphs show Hounsfield Units (HU) value profiles of the CT image along the lines for the occluded (B) and the normal (C) MCA segment.
CT image of a patient with stroke (A). In the selected slice, Middle Cerebral Artery (MCA) on both hemispheres of the brain is visible. The occluded MCA section on the right hemisphere and its symmetrical normal MCA section is indicated by a yellow line along the cerebral thrombus. Graphs show Hounsfield Units (HU) value profiles of the CT image along the lines for the occluded (B) and the normal (C) MCA segment.

Figure 3

Graphs of correlation among different data groups. Shown are six graphs of data group pairs from Table 2 that have the highest Pearson coefficients and also statistically most significant linear regression parameters.
Graphs of correlation among different data groups. Shown are six graphs of data group pairs from Table 2 that have the highest Pearson coefficients and also statistically most significant linear regression parameters.

Linear regression and Pearson correlation coefficient analysis of data group pairs with statistically most significant correlations and linear regression parameters

Data group pair Linear regression y = k· x + n Pearson coefficient
x-values y-values k p-value R2 ρ
HU avg occl mRS end 0.227 ± 0.086 0.015 0.233 0.483
HU avg occl # passes 0.119 ± 0.052 0.031 0.186 0.432
HU avg occl mRS diff -0.140 ± 0.067 0.049 0.158 -0.398
HU avg diff RBC [%] 1.646 ± 0.809 0.053 0.153 0.391
HU avg occl mRS start 0.087 ± 0.045 0.065 0.140 0.374
HU avg diff mRS diff -0.104 ± 0.059 0.093 0.118 -0.343

Experimental data of patients qualified for the study, which include CT, histological, clinical and procedure parameters

CT parameters
 Histology Clinical parameters
 Procedure parameters
# HU avg
 HU var
 Stroke etiology Therapy before stoke NIHSS
 mRS
occl nor diff diff [%] occl nor diff diff [%] L [mm] RBC [%] strt end diff strt end diff Rd [min] # pass
1. 29.1 32.4 -3.3 -11.4 4.20 4.42 -0.22 -5.0 20.8 11.5 AT / 21 1 20 4 1 3 42 1
2. 42.0 29.2 12.8 30.5 4.58 8.98 -4.40 -96.3 16.3 45.1 CE / 17 8 9 5 4 1 62 2
3. 38.5 35.1 3.4 8.9 3.56 2.75 0.80 22.6 17.0 12.0 CE / 23 7 16 4 3 1 65 1
4. 36.9 34.3 2.5 6.8 11.66 4.58 7.08 60.7 17.5 41.4 CE AA 18 3 15 5 2 3 77 1
5. 43.7 44.2 -0.5 -1.2 3.55 3.86 -0.31 -8.7 17.9 65.9 AT / 26 6 20 5 3 2 97 3
6. 35.8 30.0 5.9 16.4 4.17 2.23 1.95 46.7 16.3 61.0 CE / 7 0 7 3 0 3 38 3
7. 31.8 36.0 -4.2 -13.2 2.77 3.26 -0.49 -17.8 22.2 57.3 AT / 13 3 10 4 1 3 90 1
8. 37.8 38.9 -1.1 -2.9 2.82 4.45 -1.63 -58.0 26.9 50.3 CE / 14 3 11 4 3 1 77 1
9. 32.0 24.0 8.1 25.1 9.50 4.90 4.60 48.4 22.7 56.3 CE ACAA 5 2 3 3 2 1 115 2
10. 38.5 36.5 2.0 5.1 3.20 2.80 0.40 12.5 19.7 52.4 CE / 26 42 -16 5 6 -1 82 4
11. 38.3 39.4 -1.1 -2.8 5.49 3.66 1.83 33.4 17.1 19.1 AT / 12 0 12 3 0 3 60 1
12. 35.7 33.9 1.7 4.9 3.56 5.39 -1.83 -51.2 13.9 31.8 CE AA 6 3 3 3 1 2 69 1
13. 44.3 31.9 12.3 27.8 4.66 5.11 -0.46 -9.8 22.5 74.7 AT / 19 12 7 5 4 1 108 2
14. 44.1 37.5 6.6 15.0 2.60 3.92 -1.32 -50.9 19.3 38.9 CE / 18 20 -2 4 5 -1 63 5
15. 36.0 35.4 0.6 1.6 3.48 2.67 0.81 23.4 17.9 48.8 CE / 42 42 0 5 6 -1 75 2
16. 38.1 36.4 1.7 4.5 4.16 5.45 -1.30 -31.2 18.6 21.3 AT / 15 4 11 5 4 1 77 1
17. 42.5 40.7 1.8 4.2 3.11 3.74 -0.63 -20.4 13.5 14.8 CE AA 14 2 12 5 3 2 53 1
18. 38.7 23.3 15.4 39.8 5.66 4.79 0.87 15.3 19.1 42.4 CE AC 22 3 19 5 4 1 43 1
19. 34.7 30.9 3.8 11.0 5.61 4.43 1.18 21.1 20.9 37.7 AT / 3 1 2 1 0 1 60 1
20. 41.2 32.4 8.8 21.4 5.14 4.58 0.56 10.9 19.3 56.0 AT AC 11 40 -29 4 6 -2 76 3
21. 37.2 28.5 8.7 23.5 3.29 5.27 -1.99 -60.4 29.2 79.1 AT / 19 10 9 5 5 0 61 1
22. 35.2 32.5 2.6 7.5 3.02 2.79 0.24 7.9 13.6 9.3 CE / 16 9 7 5 5 0 95 3
23. 41.5 34.5 6.9 16.7 5.14 4.47 0.67 13.0 21.5 80.4 AT / 16 3 13 4 2 2 65 2
24. 28.9 23.2 5.6 19.5 3.52 4.72 -1.20 -34.1 12.1 57.1 CE / 13 3 10 4 1 3 55 1
25. 40.2 33.4 6.8 17.0 2.91 4.30 -1.39 -47.8 18.7 46.8 AT AA 42 42 0 5 6 -1 90 4
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