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01-11-2016 | Neuro

Added value of CT perfusion compared to CT angiography in predicting clinical outcomes of stroke patients treated with mechanical thrombectomy

Authors: Ioannis Tsogkas, Michael Knauth, Katharina Schregel, Daniel Behme, Katrin Wasser, Ilko Maier, Jan Liman, Marios Nikos Psychogios

Published in: European Radiology | Issue 11/2016

Abstract

Objectives

CTP images analyzed with the Alberta stroke program early CT scale (ASPECTS) have been shown to be optimal predictors of clinical outcome. In this study we compared two biomarkers, the cerebral blood volume (CBV)-ASPECTS and the CTA-ASPECTS as predictors of clinical outcome after thrombectomy.

Methods

Stroke patients with thrombosis of the M1 segment of the middle cerebral artery were included in our study. All patients underwent initial multimodal CT with CTP and CTA on a modern CT scanner. Treatment consisted of full dose intravenous tissue plasminogen activator, when applicable, and mechanical thrombectomy. Three neuroradiologists separately scored CTP and CTA images with the ASPECTS score.

Results

Sixty-five patients were included. Median baseline CBV-ASPECTS and CTA-ASPECTS for patients with favourable clinical outcome at follow-up were 8 [interquartile range (IQR) 8-9 and 7-9 respectively]. Patients with poor clinical outcome showed a median baseline CBV-ASPECTS of 6 (IQR 5-8, P < 0.0001) and a median baseline CTA-ASPECTS of 7 (IQR 7-8, P = 0.18). Using CBV-ASPECTS and CTA-ASPECTS raters predicted futile reperfusions in 96 % and 56 % of the cases, respectively.

Conclusions

CBV-ASPECTS is a significant predictor of clinical outcome in patients with acute ischemic stroke treated with mechanical thrombectomy.

Key Points

• CBV-ASPECTS is a significant predictor of clinical outcome.

• Single phase CTA-ASPECTS has low predictive value.

• Using CBV-ASPECTS, raters identified futile reperfusions in 96 % of the cases.

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Title: Added value of CT perfusion compared to CT angiography in predicting clinical outcomes of stroke patients treated with mechanical thrombectomy
Authors: Ioannis Tsogkas
Michael Knauth
Katharina Schregel
Daniel Behme
Katrin Wasser
Ilko Maier
Jan Liman
Marios Nikos Psychogios
Publication date: 01-11-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 11/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4257-y

2024 ASCO Annual Meeting

Springer Medicine

Added value of CT perfusion compared to CT angiography in predicting clinical outcomes of stroke patients treated with mechanical thrombectomy

Abstract

Objectives

Methods

Results

Conclusions

Key Points

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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