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Related Experiment Video

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Author Spotlight: Integrated Photoacoustic, Ultrasound, and Angiographic Tomography (PAUSAT) for NonInvasive Whole-Brain Imaging of Ischemic Stroke
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Using standard first-pass perfusion computed tomographic data to evaluate collateral flow in acute ischemic stroke.

Hui Chen1, Bing Wu1, Nan Liu1

  • 1From the Third Military Medical University, Chongqing, China (H.C.); Departments of Neurology (H.C., N.L., Y.L., W.Z., G.Z.) and Radiology (B.W.), Military General Hospital of Beijing PLA, Beijing, China; Department of Radiology, Neuroradiology Section, Stanford University, CA (M.W.); GE Healthcare, Beijing, China (Z.S.); Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, China (J.H.); and Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China (Y.Z.).

Stroke
|February 12, 2015
PubMed
Summary

Volume transfer constant (Ktrans) maps from perfusion CT effectively assess cerebral collateral circulation in acute ischemic stroke. This method predicts patient outcomes, aiding in treatment decisions for stroke patients with arterial occlusion.

Keywords:
perfusionstroke

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Area of Science:

  • Neuroimaging
  • Vascular Neurology
  • Radiology

Background:

  • Assessing cerebral collateral circulation is crucial for managing acute ischemic stroke.
  • Traditional methods like digital subtraction angiography have limitations.
  • First-pass perfusion computed tomography (CT) offers a potential non-invasive alternative.

Purpose of the Study:

  • To evaluate if volume transfer constant (Ktrans) maps from perfusion CT can serve as a biomarker for cerebral collateral circulation.
  • To determine if Ktrans maps predict clinical outcomes in acute ischemic stroke patients with proximal arterial occlusion.

Main Methods:

  • Consecutive patients with acute middle cerebral artery occlusion undergoing endovascular treatment were enrolled.
  • Collateral circulation was assessed using digital subtraction angiography, CT angiography, and Ktrans maps.
  • Correlations between radiological/clinical outcomes and collateral flow scores from Ktrans maps were analyzed.

Main Results:

  • Ktrans maps showed strong agreement with digital subtraction angiography (κ=0.8101).
  • Patients were categorized by collateral flow on Ktrans maps: poor (25), intermediate (25), good (20), and excellent (5).
  • Improved collateral circulation on Ktrans maps was significantly associated with better clinical outcomes (P<0.0001).

Conclusions:

  • Ktrans maps derived from perfusion CT are a reliable indicator of collateral circulation status in acute proximal arterial occlusion.
  • Ktrans maps are predictive of clinical outcomes in these patients.
  • This technique provides a valuable, non-invasive tool for stroke assessment.