The Value of Whole-Brain Perfusion Parameters Combined with Multiphase Computed Tomography Angiography in Predicting Hemorrhagic Transformation in Ischemic Stroke |
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| Institution: | 2. GE Healthcare, Shanghai, China;2. Division of Preventive Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan;2. Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts;2. Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada;2. Division of Brain Sciences, Department of Medicine, Hammersmith Campus, Imperial College London, London, United Kingdom;3. Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand;4. University of Athens, Athens, Greece;5. Department of Neurology, University Hospital Heidelberg, Germany;2. Department of Neurosurgery, The 904th Hospital of the Joint Logistics Support force of Chinese People''s Liberation Army, Wuxi Jiangsu Province, People''s Republic of China;3. Department of Radiology, The 904th Hospital of the Joint Logistics Support force of Chinese People''s Liberation Army, Wuxi Jiangsu Province, People''s Republic of China |
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| Abstract: | Objective: To explore the value of whole-brain perfusion parameters combined with multiphase computed tomography angiography (MP-CTA) in predicting the hemorrhagic transformation (HT) of ischemic stroke. Methods: A total of 64 patients with ischemic stroke who underwent noncontrast computed tomography, computed tomography perfusion imaging, and computed tomography angiography before treatment from August 2017 to June 2019 were included retrospectively. The perfusion parameters cerebral blood volume (CBV), cerebral blood flow (CBF), time to peak (TTP), mean transit time (MTT), time to maximum (Tmax), and permeability surface (PS) were measured by postprocessing software (Advantage Workstation 4.7 (Revolution, GE Healthcare, USA)), and their ratios between the healthy and affect side relative CBV, relative CBF, relative time to peak (rTTP), relative mean transit time (rMTT), relative Tmax, and relative permeability surface (rPS) were calculated. The differences in perfusion parameters between the HT group and the non-HT group were evaluated. The collateral circulation scores and HT rates were assessed by MP-CTA. Receiver operating characteristic curves were drawn to analyze the diagnostic efficiency of valuable parameters and their correlations with HT. The rate of HT in different treatments were compared. Results: The CBV values in the HT group were lower than those in the non-HT group (P < .05), while the TTP, MTT, Tmax, PS, rTTP, rMTT, and rPS values in the HT group were higher than those in the non-HT group (P < .05). PS (r = .63, area under curve = .881) and rPS (r = .52, area under curve = .814) were significantly correlated with HT. The combination of perfusion parameters and the MP-CTA scores can improve the diagnostic efficiency (area under curve = .891). The HT rate in the group with poor collateral (64.29%) was higher than that in the group with good collateral (11.11%). Conclusions: Whole-brain perfusion parameters and MP-CTA scores have important application value in assessing the HT risk of ischemic stroke patients before treatment. |
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