The Value of Whole-Brain Perfusion Parameters Combined with Multiphase Computed Tomography Angiography in Predicting Hemorrhagic Transformation in Ischemic Stroke

被引：22

作者：

Li, Xiang ^{[1
]}

Liu, Huan ^{[2
]}

Zeng, Wenbing ^{[1
]}

Liu, Xinghua ^{[1
]}

Wen, Yun ^{[1
]}

Xiong, Qiuxia ^{[1
]}

Yang, Ran ^{[1
]}

机构：

[1] Chongqing Three Gorges Cent Hosp, Chongqing, Peoples R China

[2] GE Healthcare, Shanghai, Peoples R China

来源：

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES | 2020年 / 29卷 / 04期

关键词：

Ischemic stroke; whole-brain perfusion; multiphase computed tomography angiography; collateral circulation; hemorrhagic transformation; ENDOVASCULAR TREATMENT; CT PERFUSION; THROMBECTOMY; THERAPY;

D O I：

10.1016/j.jstrokecerebrovasdis.2020.104690

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

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.

引用

页数：8

共 22 条

[1] A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke [J].

Berkhemer, O. A. ;

Fransen, P. S. S. ;

Beumer, D. ;

van den Berg, L. A. ;

Lingsma, H. F. ;

Yoo, A. J. ;

Schonewille, W. J. ;

Vos, J. A. ;

Nederkoorn, P. J. ;

Wermer, M. J. H. ;

van Walderveen, M. A. A. ;

Staals, J. ;

Hofmeijer, J. ;

van Oostayen, J. A. ;

Nijeholt, G. J. Lycklama A. ;

Boiten, J. ;

Brouwer, P. A. ;

Emmer, B. J. ;

de Bruijn, S. F. ;

van Dijk, L. C. ;

Kappelle, L. J. ;

Lo, R. H. ;

Van Dijk, E. J. ;

de Vries, J. ;

de Kort, P. L. M. ;

van Rooij, W. J. J. ;

van den Berg, J. S. P. ;

van Hasselt, B. A. A. M. ;

Aerden, L. A. M. ;

Dallinga, R. J. ;

Visser, M. C. ;

Bot, J. C. J. ;

Vroomen, P. C. ;

Eshghi, O. ;

Schreuder, T. H. C. M. L. ;

Heijboer, R. J. J. ;

Keizer, K. ;

Tielbeek, A. V. ;

den Hertog, H. M. ;

Gerrits, D. G. ;

van den Berg-Vos, R. M. ;

Karas, G. B. ;

Steyerberg, E. W. ;

Flach, H. Z. ;

Marquering, H. A. ;

Sprengers, M. E. S. ;

Jenniskens, S. F. M. ;

Beenen, L. F. M. ;

van den Berg, R. ;

Koudstaal, P. J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (01) :11-20

[2] Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection [J].

Campbell, B. C. V. ;

Mitchell, P. J. ;

Kleinig, T. J. ;

Dewey, H. M. ;

Churilov, L. ;

Yassi, N. ;

Yan, B. ;

Dowling, R. J. ;

Parsons, M. W. ;

Oxley, T. J. ;

Wu, T. Y. ;

Brooks, M. ;

Simpson, M. A. ;

Miteff, F. ;

Levi, C. R. ;

Krause, M. ;

Harrington, T. J. ;

Faulder, K. C. ;

Steinfort, B. S. ;

Priglinger, M. ;

Ang, T. ;

Scroop, R. ;

Barber, P. A. ;

McGuinness, B. ;

Wijeratne, T. ;

Phan, T. G. ;

Chong, W. ;

Chandra, R. V. ;

Bladin, C. F. ;

Badve, M. ;

Rice, H. ;

de Villiers, L. ;

Ma, H. ;

Desmond, P. M. ;

Donnan, G. A. ;

Davis, S. M. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) :1009-1018

[3] Baseline blood pressure but not early computed tomography changes predicts major hemorrhage after streptokinase in acute ischemic stroke [J].

Gilligan, AK ;

Markus, R ;

Read, S ;

Srikanth, V ;

Hirano, T ;

Fitt, G ;

Arends, M ;

Chambers, BR ;

Davis, SM ;

Donnan, GA .

STROKE, 2002, 33 (09) :2236-2242

[4] The cerebral collateral circulation: Relevance to pathophysiology and treatment of stroke [J].

Ginsberg, Myron D. .

NEUROPHARMACOLOGY, 2018, 134 :280-292

[5] Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke [J].

Goyal, M. ;

Demchuk, A. M. ;

Menon, B. K. ;

Eesa, M. ;

Rempel, J. L. ;

Thornton, J. ;

Roy, D. ;

Jovin, T. G. ;

Willinsky, R. A. ;

Sapkota, B. L. ;

Dowlatshahi, D. ;

Frei, D. F. ;

Kamal, N. R. ;

Montanera, W. J. ;

Poppe, A. Y. ;

Ryckborst, K. J. ;

Silver, F. L. ;

Shuaib, A. ;

Tampieri, D. ;

Williams, D. ;

Bang, O. Y. ;

Baxter, B. W. ;

Burns, P. A. ;

Choe, H. ;

Heo, J. -H. ;

Holmstedt, C. A. ;

Jankowitz, B. ;

Kelly, M. ;

Linares, G. ;

Mandzia, J. L. ;

Shankar, J. ;

Sohn, S. -I. ;

Swartz, R. H. ;

Barber, P. A. ;

Coutts, S. B. ;

Smith, E. E. ;

Morrish, W. F. ;

Weill, A. ;

Subramaniam, S. ;

Mitha, A. P. ;

Wong, J. H. ;

Lowerison, M. W. ;

Sajobi, T. T. ;

Hill, M. D. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) :1019-1030

[6] Predictors for Symptomatic Intracranial Hemorrhage After Endovascular Treatment of Acute Ischemic Stroke [J].

Hao, Yonggang ;

Yang, Dong ;

Wang, Huaiming ;

Zi, Wenjie ;

Zhang, Meng ;

Geng, Yu ;

Zhou, Zhiming ;

Wang, Wei ;

Xu, Haowen ;

Tian, Xiguang ;

Lv, Penghua ;

Liu, Yuxiu ;

Xiong, Yunyun ;

Liu, Xinfeng ;

Xu, Gelin .

STROKE, 2017, 48 (05) :1203-+

[7] Influence of procedure time on outcome and hemorrhagic transformation in stroke patients undergoing thrombectomy [J].

Huang, Xianjun ;

Cai, Qiankun ;

Xiao, Lulu ;

Gu, Mengmeng ;

Liu, Yuanlu ;

Zhou, Zhiming ;

Sun, Wen ;

Xu, Gelin ;

Liu, Xinfeng .

JOURNAL OF NEUROLOGY, 2019, 266 (10) :2560-2570

[8] Association of CT Perfusion Parameters with Hemorrhagic Transformation in Acute Ischemic Stroke [J].

Jain, A. R. ;

Jain, M. ;

Kanthala, A. R. ;

Damania, D. ;

Stead, L. G. ;

Wang, H. Z. ;

Jahromi, B. S. .

AMERICAN JOURNAL OF NEURORADIOLOGY, 2013, 34 (10) :1895-1900

[9] Thrombectomy within 8 Hours after Symptom Onset in Ischemic Stroke [J].

Jovin, T. G. ;

Chamorro, A. ;

Cobo, E. ;

de Miquel, M. A. ;

Molina, C. A. ;

Rovira, A. ;

San Roman, L. ;

Serena, J. ;

Abilleira, S. ;

Ribo, M. ;

Millan, M. ;

Urra, X. ;

Cardona, P. ;

Lopez-Cancio, E. ;

Tomasello, A. ;

Castano, C. ;

Blasco, J. ;

Aja, L. ;

Dorado, L. ;

Quesada, H. ;

Rubiera, M. ;

Hernandez-Perez, M. ;

Goyal, M. ;

Demchuk, A. M. ;

von Kummer, R. ;

Gallofre, M. ;

Davalos, A. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (24) :2296-2306

[10] Optimal thresholds for ischemic penumbra predicted by computed tomography perfusion in patients with acute ischemic stroke treated with mechanical thrombectomy [J].

Kameda, Katsuharu ;

Uno, Junji ;

Otsuji, Ryosuke ;

Ren, Nice ;

Nagaoka, Shintaro ;

Maeda, Kazushi ;

Ikai, Yoshiaki ;

Gi, Hidefuku .

JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2018, 10 (03) :279-284

← 1 2 3 →