Acute stroke: a comparison of different CT perfusion algorithms and validation of ischaemic lesions by follow-up imaging.

Objectives: To compare ischaemic lesions predicted by different CT perfusion (CTP) post-processing techniques and validate CTP lesions compared with final lesion size in stroke patients.Methods: Fifty patients underwent CT, CTP and CT angiography. Quantitative values and colour maps were calculated...

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Publicado en:European Radiology Vol. 22; no. 12; pp. 2559 - 2568
Autores principales: Abels B, Villablanca JP, Tomandl BF, Uder M, Lell MM, Abels, Benjamin, Villablanca, J Pablo, Tomandl, Bernd F, Uder, Michael, Lell, Michael M
Formato: research Journal Article
Publicado: Springer Nature Dec2012
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Acute stroke: a comparison of different CT perfusion algorithms and validation of ischaemic lesions by follow-up imaging.
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          Abels B
          Villablanca JP
          Tomandl BF
          Uder M
          Lell MM
          Abels, Benjamin
          Villablanca, J Pablo
          Tomandl, Bernd F
          Uder, Michael
          Lell, Michael M
        affil: Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
      sug:
        subj:
          Algorithms
          Cerebral Ischemia Radiography
          Stroke Radiography
          Tomography, X-Ray Computed Methods
          Aged
          Cerebral Ischemia Drug Therapy
          Coronary Angiography
          Female
          Human
          Regression
          Magnetic Resonance Imaging
          Male
          Predictive Value of Tests
          Radiographic Image Interpretation, Computer-Assisted
          Retrospective Design
          Software
          Nonparametric Statistics
          Stroke Drug Therapy
          Thrombolytic Therapy
          Aged: 65+ years
          Female
          Male
      ab: Objectives: To compare ischaemic lesions predicted by different CT perfusion (CTP) post-processing techniques and validate CTP lesions compared with final lesion size in stroke patients.Methods: Fifty patients underwent CT, CTP and CT angiography. Quantitative values and colour maps were calculated using least mean square deconvolution (LMSD), maximum slope (MS) and conventional singular value decomposition deconvolution (SVDD) algorithms. Quantitative results, core/penumbra lesion sizes and Alberta Stroke Programme Early CT Score (ASPECTS) were compared among the algorithms; lesion sizes and ASPECTS were compared with final lesions on follow-up MRI + MRA or CT + CTA as a reference standard, accounting for recanalisation status.Results: Differences in quantitative values and lesion sizes were statistically significant, but therapeutic decisions based on ASPECTS and core/penumbra ratios would have been the same in all cases. CTP lesion sizes were highly predictive of final infarct size: Coefficients of determination (R (2)) for CTP versus follow-up lesion sizes in the recanalisation group were 0.87, 0.82 and 0.61 (P < 0.001) for LMSD, MS and SVDD, respectively, and 0.88, 0.87 and 0.76 (P < 0.001), respectively, in the non-recanalisation group.Conclusions: Lesions on CT perfusion are highly predictive of final infarct. Different CTP post-processing algorithms usually lead to the same clinical decision, but for assessing lesion size, LMSD and MS appear superior to SVDD.Key Points: Following an acute stroke, CT perfusion imaging can help predict lesion evolution. Delay-insensitive deconvolution and maximum slope approach are superior to delay-sensitive deconvolution regarding accuracy. Different CT perfusion post-processing algorithms usually lead to the same clinical decision. CT perfusion offers new insights into the evolution of stroke.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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