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stroke and CT perfusion

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https://www.readbyqxmd.com/read/28530158/analyzing-circle-of-willis-blood-flow-in-ischemic-stroke-patients-through-3d-stroke-arterial-flow-estimation
#1
Aichi Chien, Fernando Viñuela
Background The objective of ischemic stroke (IS) treatment is to achieve revascularization in cerebral arteries to restore blood flow. However, there is no available method to extract arterial flow data from clinical CTA images. We developed 3D Stroke Arterial Flow Estimation (SAFE), which provides blood flow data throughout the Circle of Willis based on 3D CTA and allows comparison of arterial flow distribution in the brain. Methods We implemented a newly developed 3D vascular reconstruction algorithm for clinical stroke CTA images...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28524121/-the-use-of-high-flow-extracranial-intracranial-artery-bypass-in-pathology-of-the-cerebral-and-brachiocephalic-arteries-technical-features-and-surgical-outcomes
#2
A V Dubovoy, K S Ovsyannikov, V E Guzhin, A V Cherepanov, D M Galaktionov, A M Perfil'ev, A O Sosnov
BACKGROUND: Poor outcomes of surgical treatment for complex cerebral aneurysms due to the development of cerebral ischemia were the cause to use cerebral revascularization surgery for this pathology. OBJECTIVE: the study objective was to master a high-flow extracranial-intracranial (EC-IC) artery bypass technique and evaluate its application in surgical treatment of complex and giant cerebral aneurysms as well as complex lesions of the brachiocephalic arteries. MATERIAL AND METHODS: Fifty two patients underwent high-flow IC-EC bypass surgery; of these, 34 patients had complex cerebral aneurysms, and 18 patients had complex stenotic occlusive lesions of the brachiocephalic arteries...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28520753/comparative-accuracy-of-ct-perfusion-in-diagnosing-acute-ischemic-stroke-a-systematic-review-of-27-trials
#3
Jiantong Shen, Xianglian Li, Youping Li, Bing Wu
OBJECTIVE: To systematically evaluate and compare the diagnostic accuracy of CT perfusion (CTP), non-enhanced computed tomography (NCCT) and computed tomography angiography (CTA) in detecting acute ischemic stroke. METHODS: We searched seven databases and screened the reference lists of the included studies. The risk of bias in the study quality was assessed using QUADASII. We produced paired forest plots in RevMan to show the variation of the sensitivity and specificity estimates together with their 95% CI...
2017: PloS One
https://www.readbyqxmd.com/read/28520657/ct-based-techniques-for-brain-perfusion
#4
Pradeep Krishnan, Amanda Murphy, Richard I Aviv
Recent rapid advances in endovascular treatment for acute ischemic stroke highlight the crucial role of neuroimaging especially multimodal computed tomography (CT) including CT perfusion in stroke triage and management decisions. With an increasing focus on changes in cerebral physiology along with time-based matrices in clinical decisions for acute ischemic stroke, CT perfusion provides a rapid and practical modality for assessment and identification of salvageable tissue at risk and infarct core and provides a better understanding of the changes in cerebral physiology...
June 2017: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/28515270/evaluation-of-hyperacute-infarct-volume-using-aspects-and-brain-ct-perfusion-core-volume
#5
Jelle Demeestere, Carlos Garcia-Esperon, Pablo Garcia-Bermejo, Fouke Ombelet, Patrick McElduff, Andrew Bivard, Mark Parsons, Christopher Levi
OBJECTIVE: To compare the accuracy of Alberta Stroke Program Early Computed Tomography Score (ASPECTS) and CT perfusion to detect established infarction in acute anterior circulation stroke. METHODS: We performed an observational study in 59 acute anterior circulation ischemic stroke patients who underwent brain noncontrast CT, CT perfusion, and MRI within 100 minutes from CT imaging. ASPECTS scores were calculated by 4 blinded vascular neurologists. The accuracy of ASPECTS and CT perfusion core volume to detect an acute MRI diffusion lesion of ≥70 mL was evaluated using receiver operating characteristics analysis and optimum cutoff values were calculated using Youden J...
May 17, 2017: Neurology
https://www.readbyqxmd.com/read/28486789/ct-perfusion-to-predict-response-to-recanalization-in-ischemic-stroke
#6
Maarten G Lansberg, Soren Christensen, Stephanie Kemp, Michael Mlynash, Nishant Mishra, Christian Federau, Jenny P Tsai, Sun Kim, Raul G Nogueria, Tudor Jovin, Thomas G Devlin, Naveed Akhtar, Dileep R Yavagal, Diogo Haussen, Seena Dehkharghani, Roland Bammer, Matus Straka, Greg Zaharchuk, Michael P Marks, Gregory W Albers
OBJECTIVE: To assess the utility of CT perfusion for selection of patients for endovascular therapy up to 18 hours after symptom onset. METHODS: We conducted a multicenter cohort study of consecutive acute stroke patients scheduled to undergo endovascular therapy within 90 min after a baseline CTP. Patients were classified as 'target mismatch' if they had a small ischemic core and a large penumbra on their baseline CT perfusion. Reperfusion was defined as >50% reduction in critical hypoperfusion between the baseline CT perfusion and the 36-hour follow-up MRI...
May 9, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28465268/intracranial-blood-flow-changes-in-patients-with-high-grade-severe-carotid-artery-stenosis-after-stenting
#7
Lei Huang, Wenjie Cao, Liang Ge, Gang Lu, Xiaolong Zhang, Daoying Geng
OBJECTIVE: We investigated whether the cerebral hemodynamic changes of pre- and poststenting in patients with severe carotid stenosis differ by stenosis grades. MATERIALS AND METHODS: We prospectively recruited patients who underwent carotid artery stenting (CAS) after acute ischemic stroke from June 2014 to December 2015. We compared the mean relative cerebral blood flow changes (rCBF) (measured by whole-brain computed tomography [CT] perfusion) pre- and poststenting in patients with high-grade severe stenosis (HGSS 90%-99%) versus patients with low-grade severe stenosis (LGSS 70%-89%)...
April 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28460496/blood-pressure-may-be-associated-with-arterial-collateralization-in-anterior-circulation-ischemic-stroke-before-acute-reperfusion-therapy
#8
Beisi Jiang, Leonid Churilov, Lasheta Kanesan, Richard Dowling, Peter Mitchell, Qiang Dong, Stephen Davis, Bernard Yan
Background and Purpose: Leptomeningeal collaterals maintain arterial perfusion in acute arterial occlusion but may fluctuate subject to arterial blood pressure (ABP). We aim to investigate the relationship between ABP and collaterals as assessed by computer tomography (CT) perfusion in acute ischemic stroke. Methods: We retrospectively analyzed acute anterior circulation ischemic stroke patients with CT perfusion from 2009 to 2014. Collateral status using relative filling time delay (rFTD) determined by time delay of collateral-derived contrast opacification within the Sylvian fissure, from 0 seconds to unlimited count...
May 2, 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28457859/clinical-and-radiological-assessment-of-cerebral-hemodynamics-after-cranioplasty-for-decompressive-craniectomy-a-clinical-study
#9
Perikal J Parichay, Kiran Khanapure, Krishna C Joshi, T J Aniruddha, M Sandhya, A S Hegde
OBJECTIVES: To find the correlation between radiologically proven improvement in cerebral hemodynamics with clinical improvement in patients undergoing cranioplasty. MATERIAL AND METHODS: The study is a prospective observational study of 10 cases, in M S Ramaiah Institute of Neurosciences, involving patients treated by a decompressive craniectomy for intractable intra cranial hypertension either due to trauma or stroke and afterwards underwent cranioplasty. RESULTS: Of the 10 patients, 70% patients showing significant improvement in motor functions on Barthel index scale, 60% patients showed improvement in speech, mean duration from date of decompressive craniectomy to cranioplasty being 122...
April 27, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28454490/ct-perfusion-in-predicting-the-morbidity-and-prognosis-of-hypoxic-ischemic-encephalopathy-after-off-pump-coronary-artery-bypass-grafting
#10
Di Luo, James Yip, Zhe Song, Baolei Xu, Qi Bi
OBJECTIVE: To investigate the perfusion parameters of computed tomography (CT) in hypoxicischemic encephalopathy (HIE) after off-pump coronary artery bypass grafting (OPCABG), and its potential in predicting the occurrence and prognosis of hypoxic-ischemic encephalopathy. METHODS: We selected 830 patients. The patients were grouped into: HIE and no HIE. HIE patients were further divided into two groups: poor prognosis and better prognosis. RESULTS: (1) Patients with HIE, who had a history of stroke and hypertension, showed more severe stenosis on CTA and more perfusion abnormalities compared to non-HIE patients (p < 0...
June 2017: Neurological Research
https://www.readbyqxmd.com/read/28439614/internal-carotid-artery-stenosis-and-collateral-recruitment-in-stroke-patients
#11
Jan W Dankbaar, Kelly G P Kerckhoffs, Alexander D Horsch, Irene C van der Schaaf, L Jaap Kappelle, Birgitta K Velthuis
PURPOSE: Leptomeningeal collaterals improve outcome in stroke patients. There is great individual variability in their extent. Internal carotid artery (ICA) stenosis may lead to more extensive recruitment of leptomeningeal collaterals. The purpose of this study was to evaluate the association of pre-existing ICA stenosis with leptomeningeal collateral filling visualized with computed tomography perfusion (CTP). METHODS: From a prospective acute ischemic stroke cohort, patients were included with an M1 middle cerebral artery (MCA) occlusion and absent ipsilateral, extracranial ICA occlusion...
April 24, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28432712/stroke-etiology-and-collaterals-atheroembolic-strokes-have-greater-collateral-recruitment-than-cardioembolic-strokes
#12
L C Rebello, M Bouslama, D C Haussen, J A Grossberg, S Dehkharghani, A Anderson, S R Belagaje, N A Bianchi, M Grigoryan, M R Frankel, R G Nogueira
BACKGROUND AND PURPOSE: Chronic hypoperfusion from athero-stenotic lesions is thought to lead to better collateral recruitment compared to cardioembolic strokes. It was sought to compare collateral flow in stroke patients with atrial fibrillation (AF) versus stroke patients with cervical atherosclerotic steno-occlusive disease (CASOD). METHOD: This was a retrospective review of a prospectively collected endovascular database. Patients with (i) anterior circulation large vessel occlusion stroke, (ii) pre-treatment computed tomography angiography (CTA) and (iii) intracranial embolism from AF or CASOD were included...
April 21, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28431614/permeability-surface-area-product-analysis-in-malignant-brain-edema-prediction-a-pilot-study
#13
O Volny, P Cimflova, T-Y Lee, B K Menon, C D d'Esterre
BACKGROUND AND PURPOSE: Using an extended CT perfusion acquisition (150s), we sought to determine the association between perfusion parameters and malignant edema after ischemic stroke. METHODS: Patients (from prospective study PROVE-IT, NCT02184936) with terminal internal carotid artery±proximal middle cerebral occlusion were involved. CTA was assessed for clot location and status of leptomeningeal collaterals. The following CTP parameters were calculated within the ischemic territory and contralaterally: permeability surface area product (PS), cerebral blood flow (CBF) and cerebral blood volume (CBV)...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28414895/the-impact-of-ct-perfusion-threshold-on-predicted-viable-and-nonviable-tissue-volumes-in-acute-ischemic-stroke
#14
Xuya Huang, Dheeraj Kalladka, Bharath Kumar Cheripelli, Fiona Catherine Moreton, Keith W Muir
BACKGROUND AND PURPOSE: Perfusion imaging is used for patient selection in clinical practice and trials. Postprocessing and definitions of tissue viability are nevertheless not standardized. We compared the lesion volumes generated with two well-recognized perfusion tissue definitions in a single-center phase 2 thrombolysis study. METHODS: We analyzed perfusion imaging data from the Alteplase-Tenecteplase Trial Evaluation for Stroke Thrombolysis (ATTEST) study using two popular tissue viability thresholds (ischemic core definition: (1) cerebral blood volume < 2...
April 17, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28412909/prolonged-perfusion-predicts-recurrent-ischemic-stroke-but-not-transient-ischemic-attack-in-patients-with-symptomatic-intracranial-stenosis
#15
Linfang Lan, Xinyi Leng, Vincent Ip, Thomas Leung, Yannie Soo, Jill Abrigo, Ka Sing Wong
BACKGROUND: Intracranial arterial stenosis (ICAS) is the dominant cause for ischemic stroke worldwide, with hemodynamic compromise as a crucial contributor. Prolonged perfusion is commonly observed in ICAS patients on CT perfusion (CTP) maps, while the clinical significance of this perfusion pattern has not been elucidated. METHODS: Patients having symptomatic ICAS of 50-99% stenosis with sustained downstream cerebral blood flow (CBF) were enrolled into this study...
April 13, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28412316/differentiating-stroke-and-seizure-in-acute-setting-perfusion-computed-tomography
#16
Katarzyna Kubiak-Balcerewicz, Urszula Fiszer, Ewa Nagańska, Cezary Siemianowski, Aleksander Sobieszek, Agnieszka Witak-Grzybowska, Aldona Kosińska-Szot
BACKGROUND: Perfusion computed tomography (PCT) is part of acute stroke protocol in many hospitals; however, its clinical utility is still being disputed. Beyond its use in core and penumbra estimation, there is also a question about PCT role in stroke mimics diagnosis. Case series or small, retrospective studies showed equivocal results. This is the first published prospective, comparative study on PCT in differentiating stroke and seizure in acute setting. METHODS: Patients with acute focal neurologic deficits and without acute ischemic lesions on routine CT underwent PCT and electroencephalography (EEG) within 12 hours after symptom onset...
April 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28386041/prevalence-of-imaging-biomarkers-to-guide-the-planning-of-acute-stroke-reperfusion-trials
#17
Bin Jiang, Robyn L Ball, Patrik Michel, Tudor Jovin, Manisha Desai, Ashraf Eskandari, Zack Naqvi, Max Wintermark
BACKGROUND AND PURPOSE: Imaging biomarkers are increasingly used as selection criteria for stroke clinical trials. The goal of our study was to determine the prevalence of commonly studied imaging biomarkers in different time windows after acute ischemic stroke onset to better facilitate the design of stroke clinical trials using such biomarkers for patient selection. METHODS: This retrospective study included 612 patients admitted with a clinical suspicion of acute ischemic stroke with symptom onset no more than 24 hours before completing baseline imaging...
April 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28364137/hypoattenuation-on-cta-images-with-large-vessel-occlusion-timing-affects-conspicuity
#18
Prasham Dave, Cheemun Lum, Rebecca Thornhill, Santanu Chakraborty, Dar Dowlatshahi
PURPOSE: Parenchymal hypoattenuation distal to occlusions on CTA source images (CTASI) is perceived because of the differences in tissue contrast compared to normally perfused tissue. This difference in conspicuity can be measured objectively. We evaluated the effect of contrast timing on the conspicuity of ischemic areas. METHODS: We collected consecutive patients, retrospectively, between 2012 and 2014 with large vessel occlusions that had dynamic multiphase CT angiography (CTA) and CT perfusion (CTP)...
May 2017: Neuroradiology
https://www.readbyqxmd.com/read/28328241/perfusion-ct-in-acute-stroke-effectiveness-of-automatically-generated-colour-maps
#19
Maja Ukmar, Ferruccio Degrassi, Roberta Antea Pozzi Mucelli, Francesca Neri, Fabio Pozzi Mucelli, Maria Assunta Cova
OBJECTIVE: To evaluate the accuracy of perfusion CT (pCT) in the definition of the infarcted core and the penumbra, comparing the data obtained from the evaluation of parametric maps [cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT)] with software-generated colour maps. METHODS: A retrospective analysis was performed to identify patients with suspected acute ischaemic strokes and who had undergone unenhanced CT and pCT carried out within 4...
April 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28320175/mechanical-embolectomy-for-acute-ischemic-stroke-beyond-six-hours-from-symptom-onset-using-mri-based-perfusion-imaging
#20
Ryan A McTaggart, Shadi Yaghi, Daniel C Sacchetti, Richard A Haas, Morgan Hemendinger, Daniel Arcuri, Jeffrey M Rogg, Karen L Furie, Mahesh V Jayaraman
INTRODUCTION: There is very limited data on the use of MRI based perfusion imaging to select patients with acute ischemic stroke and large vessel occlusion (LVO) for intraarterial therapy beyond 6h from onset. Our aim is to report the outcome of patients with acute ischemic stroke and large artery occlusion who presented beyond 6h from onset, had favorable MRI imaging profile, and underwent mechanical embolectomy. METHODS: This is a single institution (Rhode Island Hospital) retrospective study between December 1st, 2015, and July 30th, 2016 that included patients with acute ischemic stroke and proximal LVO with CT ASPECTS of 6 or more and 6-24h from symptom onset who were assessed for mechanical embolectomy using MRI based perfusion imaging...
April 15, 2017: Journal of the Neurological Sciences
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