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Related Concept Videos

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A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model
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Perfusion Computed Tomography Accurately Quantifies Collateral Flow After Acute Ischemic Stroke.

Longting Lin1, Chushuang Chen1, Huiqiao Tian1

  • 1From the School of Medicine and Public Health (L.L., C.C., H.T., N.S., C.R.L., M.W.P.), University of Newcastle, Australia.

Stroke
|January 18, 2020
PubMed
Summary
This summary is machine-generated.

Computed tomographic perfusion accurately quantifies collateral flow in acute ischemic stroke. A novel collateral index derived from delay time effectively predicts clinical outcomes, matching dynamic CT angiography performance.

Keywords:
area under curveedetic acidhumansperfusion imagingstroke

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Acute ischemic stroke management relies on assessing collateral circulation.
  • Computed tomographic perfusion (CTP) offers a potential method for collateral assessment.

Purpose of the Study:

  • To derive and validate an optimal collateral measurement using CTP.
  • To compare CTP-derived collateral index with dynamic CT angiography (CTA) for predicting clinical outcomes.

Main Methods:

  • Step 1: Derived optimal collateral threshold in 22 patients using receiver operating characteristic analysis on pial arterial zones.
  • Step 2: Calculated CTP collateral index and compared its predictive power to dynamic CTA collateral scores in 156 patients.

Main Results:

  • Optimal collateral threshold identified as delay time >6 s (88% sensitivity, 92% specificity).
  • CTP collateral index correlated significantly with dynamic CTA scores (r=0.62, P<0.001).
  • CTP collateral index demonstrated similar predictive power for good clinical outcome as dynamic CTA (AUC 0.78 vs. 0.77).

Conclusions:

  • CTP can accurately quantify collateral flow in acute ischemic stroke.
  • The derived CTP collateral index is a valuable tool for predicting patient outcomes.