Аннотация:Abstract — WCN 2013
No: 1742
Topic: 3 — Stroke
Prediction of tissue outcome in acute stroke with perfusion CT
D. Sergeeva
, A. Suslinb
, A. Sergeevab
, M. Piradova
, M. Krotenkovab
. a
Intensive Care, Research Center of Neurology, Russian Academy of
Medical Sciences, Moscow, Russia; b
Radiology, Research Center of
Neurology, Russian Academy of Medical Sciences, Moscow, Russia
Background: Perfusion CT allows assessment of tissue viability in
acute cerebral ischemia.
Objective: To evaluate the outcome of ischemic tissue depending on
the initial perfusion deficit.
Patients and methods: Thirty patients (21 men, median age
59 years) with acute hemispheric stroke in the first 24 h of
symptoms onset underwent perfusion CT on admission and noncontrast
CT on Day 10. Relative (intact/affected side) values of
perfusion parameters within hypoperfused area on initial perfusion
CT scan in the regions corresponding to hypodense and normal
tissue zones on non-contrast CT were studied with ROC analysis. No
patients were eligible for recanalization therapies, and received
standard antiplatelet treatment and supportive care.
Results: Median initial NIHSS score was 8.1. Thresholds for relative
values of perfusion parameters indicating tissue survival (i.e., no
infarction on final CT scan) were 5.06 for rCBF, 1.13 for rCBV, and
0.41 for rMTT. Despite no difference was found between areas under
ROC curves (p N 0.05), AUROC value was numerically higher for rCBV
(0.84 vs 0.80 vs 0.59 compared with values for rCBF and rMTT,
respectively). The rCBV threshold had sensitivity of 88.9% and
specificity of 75.0%.
Conclusion: In patients with acute stroke who did not receive
thrombolysis the viability of tissue can be best predicted with the
change of CBV parameter relative to intact tissue on initial perfusion
CT, with decrease of CBV N 13% indicating worse tissue outcome.
doi:10.1016/j.jns.2013.07.848