In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 35, No. 7 ( 2004-07), p. 1652-1658
Abstract:
Background and Purpose— We aimed to determine the diagnostic value of perfusion computed tomography (PCT) and CT angiography (CTA) including CTA source images (CTA-SI) in comparison with perfusion-weighted magnetic resonance imaging (MRI) (PWI) and diffusion-weighted MRI (DWI) in acute stroke 〈 6 hours. Methods— Noncontrast-enhanced CT, PCT, CTA, stroke MRI, including PWI and DWI, and MR angiography (MRA), were performed in patients with symptoms of acute stroke lasting 〈 6 hours. We analyzed ischemic lesion volumes on patients’ arrival as shown on NECT, PCT, CTA-SI, DWI, and PWI (Wilcoxon, Spearman, Bland-Altman) and compared them to the infarct extent as shown on day 5 NECT. Results— Twenty-two stroke patients underwent CT and MRI scanning within 6 hours. PCT time to peak (PCT-TTP) volumes did not differ from PWI-TTP ( P =0.686 for patients who did not undergo thrombolysis/ P =0.328 for patients who underwent thrombolysis), nor did PCT cerebral blood volume (PCT-CBV) differ from PWI-CBV ( P =0.893/ P =0.169). CTA-SI volumes did not differ from DWI volumes ( P =0.465/ P =0.086). Lesion volumes measured in PCT maps significantly correlated with lesion volumes on PWI ( P =0.0047, r =1.0/ P =0.0019, r =0.897 for TTP; P =0.0054, r =0.983/ P =0.0026, r =0.871 for CBV). Also, PCT-CBV lesion volumes significantly correlated with follow-up CT lesion volumes ( P =0.0047, r =1.0/ P =0.0046, r =0.819). Conclusions— In hyperacute stroke, the combination of PCT and CTA can render important diagnostic information regarding the infarct extent and the perfusion deficit. Lesions on PCT-TTP and PCT-CBV do not differ from lesions on PWI-TTP and PWI-CBV; lesions on CTA source images do not differ from lesions on DWI. The combination of noncontrast-enhanced CT (NECT), perfusion CT (PCT), and CT angiography (CTA) can render additional information within 〈 15 minutes and may help in therapeutic decision-making if PWI and DWI are not available or cannot be performed on specific patients.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/01.STR.0000131271.54098.22
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2004
detail.hit.zdb_id:
1467823-8
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