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Predictive value of whole-brain CT perfusion combined with ABCD3 score for short-term secondary cerebral infarction
Shushu Liu1,2, Ting Chen1, Wei Wu1
1Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Insights
Whole Brain CT Perfusion (WB-CTP) combined with the ABCD3 score effectively predicts secondary cerebral infarction in transient ischemic attack (TIA) patients within 90 days. This combined model offers a promising tool for early risk stratification and management.
Area of Science:
- Neurology
- Radiology
- Cardiovascular Medicine
Background:
- Transient ischemic attack (TIA) is a critical warning sign for subsequent stroke.
- Accurate prediction of secondary cerebral infarction risk after TIA is essential for timely intervention.
- Current predictive models may benefit from advanced imaging techniques.
Purpose of the Study:
- To evaluate the predictive capability of Whole Brain CT Perfusion (WB-CTP) in conjunction with the ABCD3 score for secondary cerebral infarction post-TIA.
- To identify key imaging and clinical factors associated with increased risk of cerebral infarction after TIA.
Main Methods:
- A cohort of 336 TIA patients underwent WB-CTP and ABCD3 score assessment within 48 hours of admission.
- Spearman correlation and logistic regression analyses were employed to determine relationships and independent risk factors.
- Receiver operating characteristic (ROC) curves and calibration plots were used to assess the predictive performance of individual parameters and the combined model.
Main Results:
- The study found correlations between vascular stenosis, perfusion parameters (rTmax, rMTT, rCBF, rCBV), and the ABCD3 score.
- Relative cerebral blood flow (rCBF) ≤ 0.8205, degree of vascular stenosis, and ABCD3 score > 6 were identified as independent predictors of secondary cerebral infarction within 90 days.
- The combined WB-CTP-ABCD3 model demonstrated a significant predictive value with an Area Under the Curve (AUC) of 0.836.
Conclusions:
- The integration of WB-CTP and the ABCD3 score provides a robust and promising approach for predicting secondary cerebral infarction in TIA patients.
- This combined model can aid clinicians in identifying high-risk individuals who may benefit from closer monitoring and more aggressive treatment strategies.
Objective:
To investigate the predictive value of Whole Brain CT Perfusion (WB-CTP) combined with the ABCD3 score in patients with transient ischemic attack (TIA).
Methods:
A total of 336 TIA patients with TIA underwent WB-CTP and ABCD3 score assessment within 48 h of admission. Spearman correlation test was performed to analyze the relationship between the degree of vascular stenosis, relative perfusion values, and ABCD3 score. Logistic regression analysis was used to identify independent risk factors for secondary cerebral infarction. Receiver operating characteristic (ROC) curves were generated to evaluate the predictive value of relative cerebral blood flow (rCBF), degree of vascular stenosis, ABCD3 score, and the WB-CTP-ABCD3 combined model for secondary cerebral infarction after TIA. Calibration curves and H-L tests were used to evaluate the predictive efficacy of the model.
Results:
Among the 336 TIA patients, 143 showed abnormal perfusion areas and 146 had responsible vessel stenosis. The degree of vascular stenosis, relative time-to-maximum (rTmax), and relative mean transit time (rMTT) were positively correlated with the ABCD3 score, while rCBF and relative cerebral blood volume (rCBV) were negatively correlated with the ABCD3 score. ROC curve analysis identified a cutoff value of 0.8205 for rCBF, with a sensitivity of 84.10% and specificity of 58.10% for distinguishing the cerebral infarction group from the non-cerebral infarction group. Furthermore, rCBF ≤ 0.8205, degree of vascular stenosis, and ABCD3 score > 6 were identified as independent risk factors for secondary cerebral infarction in TIA patients within 90 days in TIA patients. The AUC of the WB-CTP-ABCD3 combined model for predicting secondary cerebral infarction within 90 days was 0.836. The model risk was assessed by plotting calibration curves. The value of p for the H-L goodness of fit test was 0.366 (p > 0.05), which indicated that the difference between the obtained model and the perfect model were statistically insignificant.
Conclusion:
The combined model of WB-CTP-ABCD3 shows promise as a valuable method for predicting secondary cerebral infarction within 90 days following TIA.
