Clinical outcome and imaging follow-up in acute stroke patients with normal perfusion CT and normal CT angiography

Eckert, Bernd; Küsel, Tobias; Leppien, Andreas; Michels, Peter; Müller-Jensen, A.; Fiehler, Jens

doi:10.1007/s00234-010-0702-9

Cited by 27 publications

(26 citation statements)

References 16 publications

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“…Another study by Huisa found that sensitivity and specificity of CTP were increased to 81% and 91% when they selected MCA territory strokes >5cc [44]. The study by Eckert showed that the sensitivity of CTP was higher in group which with average NIHSS = 8.3 than in group which with NIHSS = 4.4 (100% vs 42.6%)[15]. The study by Rother showed that the sensitivity of CTP in group with NIHSS>10 was higher than sensitivity of CTP in group with NIHSS<10(100% vs 33%)[28].…”

Section: Discussionmentioning

confidence: 99%

Comparative accuracy of CT perfusion in diagnosing acute ischemic stroke: A systematic review of 27 trials

Shen

et al. 2017

PLoS ONE

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ObjectiveTo 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.MethodsWe 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. We used a hierarchical summary ROC model to summarize the sensitivity and specificity of CTP in detecting ischemic stroke.ResultsWe identified 27 studies with a total of 2168 patients. The pooled sensitivity of CTP for acute ischemic stroke was 82% (95% CI 75–88%), and the specificity was 96% (95% CI 89–99%). CTP was more sensitive than NCCT and had a similar accuracy with CTA. There were no statistically significant differences in the sensitivity and specificity between patients who underwent CTP within 6 hours of symptom onset and beyond 6 hours after symptom onset. No adverse events were reported in the included studies.ConclusionsCTP is more accurate than NCCT and has similar accuracy to CTA in detecting acute ischemic stroke. However, the evidence is not strong. There is potential benefit of using CTP to select stroke patients for treatment, but more high-quality evidence is needed to confirm this result.

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Section: Discussionmentioning

confidence: 99%

Comparative accuracy of CT perfusion in diagnosing acute ischemic stroke: A systematic review of 27 trials

Shen

et al. 2017

PLoS ONE

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“…However, small or infratentorial infarctions may be missed on CT due to the lower sensitivity [37], and the rate of 14% of all patients without any infarction on follow-up imaging may be actually lower. On the other hand, at 18 h after infarction onset, vasogenic edema may be present and misinterpreted as infarction.…”

Section: Limitationsmentioning

confidence: 93%

Early venous drainage after successful endovascular recanalization in ischemic stroke — a predictor for final infarct volume?

et al. 2011

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“…The bibliographies of the included articles did not result in the inclusion of additional studies, thereby validating the applied search string. After screening the full text of these 60 articles, 15 articles [1,12,13,14,15,16,17,18,19,20,21,22,23,24,25] were finally included in the current study. A flow chart of the inclusion of studies is provided in figure 1.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic Accuracy of CT Perfusion Imaging for Detecting Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

Biesbroek¹,

Niesten

Dankbaar

et al. 2013

Cerebrovasc Dis

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Background: The aim of the current study was to determine the sensitivity and specificity of CT perfusion (CTP) for the detection of ischemic strokeby performing a systematic review and meta-analysis of published reports. Methods: We searched PubMed, Embase and the Cochrane library using the terms ‘perfusion computed tomography', ‘ischemic stroke' and synonyms. We included studies that: (1) reported original data, (2) studied the diagnostic value of CTP for detecting ischemic stroke, (3) used MRI-DWI, follow-up MRI or follow-up CT as the reference standard, (4) included at least 10 patients who were suspected of ischemic stroke, and (5) reported the number of true positives, true negatives, false positives and false negatives for the diagnosis of ischemic stroke. Results: Fifteen studies were finally included in the current review with a total of 1,107 patients. A pooled analysis resulted in a sensitivity of 80% (95% confidence interval, CI: 72-86%) and a specificity of 95% (95% CI: 86-98%). Almost two thirds of the false negatives were due to small lacunar infarcts; the remaining false negatives were mostly due to limited coverage. Conclusions: The current systematic review shows that CTP has a high sensitivity and a very high specificity for detecting infarcts.

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Clinical outcome and imaging follow-up in acute stroke patients with normal perfusion CT and normal CT angiography

Abstract: MMCT sensitivity in acute lacunar or infratentorial stroke was poor. But, we found a high specifity and a fairly good sensitivity in territorial infarct detection. In acute stroke patients with normal MMCT findings on admission, a good clinical prognosis can be expected.

Cited by 27 publications

References 16 publications

Comparative accuracy of CT perfusion in diagnosing acute ischemic stroke: A systematic review of 27 trials

Comparative accuracy of CT perfusion in diagnosing acute ischemic stroke: A systematic review of 27 trials

Early venous drainage after successful endovascular recanalization in ischemic stroke — a predictor for final infarct volume?

Diagnostic Accuracy of CT Perfusion Imaging for Detecting Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

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