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Published on: September 25, 2019
Follow-Up Infarct Volume Prediction by CTP-Based Hypoperfusion Index, and the Discrepancy between Small Follow-Up
Pengyu Zhou1, Ran Li1, Siyun Liu2
1Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610056, China.
Insights
A predictive model for follow-up infarct volume (FIV) in acute ischemic stroke patients was developed. Baseline factors like hypoperfusion index (HI) predict FIV, while hypertension and smoking impact outcomes in small infarcts.
Area of Science:
- Neuroscience
- Radiology
- Cardiology
Background:
- Follow-up infarct volume (FIV) is crucial for prognostication in acute ischemic stroke.
- Predictors of the discrepancy between FIV and 90-day outcomes require further investigation.
Purpose of the Study:
- To develop a comprehensive predictive model for FIV in acute ischemic stroke patients.
- To identify factors associated with the discrepancy between FIV and long-term functional outcomes.
Main Methods:
- Utilized CT Perfusion (CTP)-based hypoperfusion index (HI) and non-contrast CT (NCCT)-based e-ASPECT.
- Employed multiple linear regression for predictive model construction.
- Conducted subgroup analysis for factors influencing outcomes in patients with small FIV (<70 mL).
Main Results:
- Developed a predictive model for FIV incorporating baseline e-ASPECT, infarct core volume, hypoperfusion volume, HI, INR, and successful recanalization.
- Identified baseline NIHSS, hypertension, stroke history, and tobacco use as predictors of poor outcomes in patients with small FIV.
- The hypoperfusion index (HI) was a significant factor in the FIV predictive model.
Conclusions:
- A comprehensive FIV predictive model, including HI, was successfully constructed.
- Baseline hypertension and smoking status are critical for functional outcomes in patients with small FIV, highlighting modifiable risk factors.
Abstract:
(1) Background: Follow-up infarct volume (FIV) may have implications for prognostication in acute ischemic stroke patients. Factors predicting the discrepancy between FIV and 90-day outcomes are poorly understood. We aimed to develop a comprehensive predictive model of FIV and explore factors associated with the discrepancy. (2) Methods: Patients with acute anterior circulation large vessel occlusion were included. Baseline clinical and CT features were extracted and analyzed, including the CTP-based hypoperfusion index (HI) and the NCCT-based e-ASPECT, measured by automated software. FIV was assessed on follow-up NCCT at 3−7 days. Multiple linear regression was used to construct the predictive model. Subgroup analysis was performed to explore factors associated with poor outcomes (90-mRS scores 3−6) in small FIV (<70 mL). (3) Results: There were 170 patients included. Baseline e-ASPECT, infarct core volume, hypoperfusion volume, HI, baseline international normalized ratio, and successful recanalization were associated with FIV and included in constructing the predictive model. Baseline NIHSS, baseline hypertension, stroke history, and current tobacco use were associated with poor outcomes in small FIV. (4) Conclusions: A comprehensive predictive model (including HI) of FIV was constructed. We also emphasized the importance of hypertension and smoking status at baseline for the functional outcomes in patients with a small FIV.
