Miniatura

Fitxers

891097.pdf (1.7 MB)

Tipus de document

Article

Versió

Versió acceptada

Data de publicació

2024-06-13

Llicència de publicació

cc-by-nc-nd (c) European Stroke Journal, 2024
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/219888

Computed tomography perfusion as an early predictor of malignant cerebral infarction

Títol de la revista

Autors

Director/Tutor

ISSN de la revista

Títol del volum

Recurs relacionat

https://doi.org/10.1177/23969873241260965

Resum

Introduction: Malignant middle cerebral artery infarction (MCI) needs rapid intervention. This study aimed to enhance the prediction of MCI using computed tomography perfusion (CTP) with varied quantitative benchmarks. Materials and methods: We retrospectively analyzed 253 patients from a single-center registry presenting with acute, severe, proximal large vessel occlusion studied with whole-brain CTP imaging at hospital arrival within the first 24 h of symptoms-onset. MCI was defined by clinical and imaging criteria, including decreased level of consciousness, anisocoria, death due to cerebral edema, or need for decompressive craniectomy, together with midline shift ⩾6 mm, or infarction of more than 50% of the MCA territory. The predictive accuracy of baseline ASPECTS and CTP quantifications for MCI was assessed by receiver operating characteristic (ROC) area under the curve (AUC) while F-score was calculated as an indicator of precision and sensitivity. Results: Sixty-three out of 253 patients (25%) fulfilled MCI criteria and had worse clinical and imaging results than the non-MCI group. The capacity to predict MCI was lower for baseline ASPECTS (AUC 0.83, F-score 0.52, Youden's index 6), than with perfusion-based measures: relative cerebral blood volume threshold <40% (AUC 0.87, F-score 0.71, Youden's index 34 mL) or relative cerebral blood flow threshold <35% (AUC 0.87, F-score 0.62, Youden's index 67 mL). CTP based on rCBV measurements identified twice as many MCI as baseline CT ASPECTS. Discussion and conclusion: CTP-based quantifications may offer enhanced predictive capabilities for MCI compared to non-contrast baseline CT ASPECTS, potentially improving the monitoring of severe ischemic stroke patients at risk of life-threatening edema and its treatment.

Matèries

Vasos sanguinis, Oclusions arterials, Infart cerebral, Tomografia computada per emissió de fotó simple, Artèries caròtides

Matèries (anglès)

Blood vessels, Arterial occlusions, Cerebral infarctio, Single-photon emission computed tomography, Carotid artery

Citació

Col·leccions

Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

RODRÍGUEZ VÁZQUEZ, Alejandro, LAREDO, Carlos, REYES, Luis, DOLZ ALVAREZ DE LA BALLINA, Guillem, DONCEL MORIANO, Antonio, LLANSÓ, Laura, RUDILOSSO, Salvatore, LLULL, Laura, RENÚ, Arturo, AMARO, Sergio, TORNÉ, Ramón, URRA, Xabier, CHAMORRO SÁNCHEZ, Ángel. Computed tomography perfusion as an early predictor of malignant cerebral infarction. _European Stroke Journal_. 2024. Vol. 10, núm. 1. [consulta: 11 de febrer de 2026]. ISSN: 2396-9873. [Disponible a: https://hdl.handle.net/2445/219888]

Exportar metadades

JSON - METS

Compartir registre