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01-10-2007 | Neuro

Perfusion CT in acute stroke: prediction of vessel recanalization and clinical outcome in intravenous thrombolytic therapy

Authors: Stephan P. Kloska, Ralf Dittrich, Tobias Fischer, Darius G. Nabavi, Roman Fischbach, Peter Seidensticker, Nani Osada, E. Bernd Ringelstein, Walter Heindel

Published in: European Radiology | Issue 10/2007

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 ≤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.

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Title: Perfusion CT in acute stroke: prediction of vessel recanalization and clinical outcome in intravenous thrombolytic therapy
Authors: Stephan P. Kloska
Ralf Dittrich
Tobias Fischer
Darius G. Nabavi
Roman Fischbach
Peter Seidensticker
Nani Osada
E. Bernd Ringelstein
Walter Heindel
Publication date: 01-10-2007
Publisher: Springer-Verlag
Published in: European Radiology / Issue 10/2007
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-007-0696-9

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Perfusion CT in acute stroke: prediction of vessel recanalization and clinical outcome in intravenous thrombolytic therapy

Abstract

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Abstract

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