Functional perfusion and blood-brain barrier permeability images in the diagnosis of cerebral tumors by angio CT

Bartolini, A.; Gasparetto, B.; Furlan, Mauro; Sullo, L.; Trivelli, G.; Albano, C.; Roncallo, F.

doi:10.1016/0895-6111(94)90023-x

Cited by 11 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…15, 30, 31 A relatively simple and frequently applied model to calculate BBBP is the Patlak model. 32,33 Applying this model to PCT data 15,34-36 requires using arterial and parenchymal contrast enhancement curves to calculate the rate of contrast transfer from the intravascular to the extravascular compartment, which is a measure of BBBP. Microvascular permeability (expressed as the transendothelial transfer constant [kPS] or permeability surface area product [PS]) is a metric of BBB integrity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Increased Blood–Brain Barrier Permeability on Perfusion CT Might Predict Malignant Middle Cerebral Artery Infarction

Bektaş

Kasam

et al. 2010

Stroke

View full text Add to dashboard Cite

Background and Purpose Perfusion computerized tomography (PCT) has been used to assess the extent of blood brain barrier (BBB) breakdown. The purpose of this study was to determine the predictive value of (BBB) permeability (BBBP) measured using PCT for development of malignant middle cerebral artery infarction (MMCA) requiring hemicraniectomy (HC). Methods We retrospectively identified patients from our stroke registry that had MCA infarction and were evaluated with admission PCT. BBBP and cerebral blood volume (CBV) maps were generated and infarct volumes calculated. Clinical and radiographic characteristics were compared between those who underwent HC versus those who did not undergo hemicraniectomy (NHC). Results 122 patients (12 (HC), 110 (NHC)) were identified. 12 patients who underwent HC had developed edema, midline shift or infarct expansion. Infarct permeability area (IParea), infarct CBV area (ICBVarea), and infarct volumes were significantly different (p<0.018, p<0.0211, p<0.0001, p<0.0014) between HC and NHC groups. Age (p=0.03) and admission National Institutes of Health Stroke Scale (NIHSS) (p=0.0029) were found to be independent predictors for HC. Using logistic regression modeling, there was an association between increased IParea and HC. The odds ratio for HC based on a 5, 10, 15 or 20 cm2 increase in IParea were 1.179, 1.390, 1.638 or 1.932, respectively (95% CI 1.035-1.343, 1.071-1.804, 1.108-2.423, 1.146-3.255). Conclusion Increased IParea is associated with an increased likelihood for undergoing HC. Since early HC for MMCA has been associated with better outcomes, the IParea on admission PCT might be a useful tool to predict MMCA and need for HC.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Similar to the standard perfusion metrics, PS can also be calculated using dynamic imaging by measuring the leakage of an intravascular tracer into the extravascular (interstitial) space. 33, 37, 38 …”

Section: Discussionmentioning

confidence: 99%

Increased Blood–Brain Barrier Permeability on Perfusion CT Might Predict Malignant Middle Cerebral Artery Infarction

Bektaş

Kasam

et al. 2010

Stroke

View full text Add to dashboard Cite

show abstract

“…Direct measurement of BBB permeability (BBBP) by using perfusion CT (PCT) has also been attempted. [6][7][8][9][10][11][12][13][14] A relatively simple and frequently applied model to calculate BBBP is the Patlak model. 15,16 Applying this model to PCT data 6,9-13 means using arterial and parenchymal contrast enhancement curves to calculate the rate of contrast transfer from an intravascular to an extravascular compartment, which is a measure of BBBP.…”

mentioning

confidence: 99%

Dynamic Perfusion CT Assessment of the Blood-Brain Barrier Permeability: First Pass versus Delayed Acquisition

Dankbaar¹,

Hom²,

Schneider³

et al. 2008

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE:The Patlak model has been applied to first-pass perfusion CT (PCT) data to extract information on blood-brain barrier permeability (BBBP) to predict hemorrhagic transformation in patients with acute stroke. However, the Patlak model was originally described for the delayed steady-state phase of contrast circulation. The goal of this study was to assess whether the first pass or the delayed phase of a contrast bolus injection better respects the assumptions of the Patlak model for the assessment of BBBP in patients with acute stroke by using PCT.

show abstract

“…It remains to be clarified if an abnormally increased BBB permeability on PCT is an indicator for early decompressive craniectomy to improve patients' outcomes. 83 Dittrich et al 13 have also reported that if the volume of the infarct core is larger than 100 cm 3 , it is likely to increase the risk of malignant infarction that might require prompt craniectomy. These data are compatible with the data of Oppenheim et al, 55 who used the volume of the diffusion-weighted MRI abnormality to predict massive brain edema.…”

Section: Acute Ischemic Strokementioning

confidence: 99%

“…3,59 Microvascular permeability is a metric of BBB integrity and is calculated by measuring the leakage of an intravascular tracer into the extravascular (interstitial) space. 3 We describe below how the PCT technique can be used to enhance diagnosis and guide treatment of patients with cerebrovascular conditions (including stroke, moyamoya disease, and vasospasm), TBI, and brain tumors.…”

Section: The General Concept Of Pct and The Assessment Of Cerebral Vamentioning

confidence: 99%

Clinical application of perfusion computed tomography in neurosurgery

Huang

Tsai

Kuo

et al. 2014

JNS

View full text Add to dashboard Cite

Object Currently, perfusion CT (PCT) is a valuable imaging technique that has been successfully applied to the clinical management of patients with ischemic stroke and aneurysmal subarachnoid hemorrhage (SAH). However, recent literature and the authors' experience have shown that PCT has many more important clinical applications in a variety of neurosurgical conditions. Therefore, the authors share their experiences of its application in various diseases of the cerebrovascular, neurotraumatology, and neurooncology fields and review the pertinent literature regarding expanding PCT applications for neurosurgical conditions, including pitfalls and future developments. Methods A pertinent literature search was conducted of English-language articles describing original research, case series, and case reports from 1990 to 2011 involving PCT and with relevance and applicability to neurosurgical disorders. Results In the cerebrovascular field, PCT is already in use as a diagnostic tool for patients suspected of having an ischemic stroke. Perfusion CT can be used to identify and define the extent of the infarct core and ischemic penumbra core, and thus aid patient selection for acute reperfusion therapy. For patients with aneurysmal SAH, PCT provides assessment of early brain injury, cerebral ischemia, and infarction, in addition to vasospasm. It may also be used to aid case selection for aggressive treatment of patients with poor SAH grade. In terms of oncological applications, PCT can be used as an imaging biomarker to assess angiogenesis and response to antiangiogenetic treatments, differentiate between glioma grades, and distinguish recurrent tumor from radiation necrosis. In the setting of traumatic brain injury, PCT can detect and delineate contusions at an early stage. In patients with mild head injury, PCT results have been shown to correlate with the severity and duration of postconcussion syndrome. In patients with moderate or severe head injury, PCT results have been shown to correlate with patients' functional outcome. Conclusions Perfusion CT provides quantitative and qualitative data that can add diagnostic and prognostic value in a number of neurosurgical disorders, and also help with clinical decision making. With emerging new technical developments in PCT, such as characterization of blood-brain barrier permeability and whole-brain PCT, this technique is expected to provide more and more insight into the pathophysiology of many neurosurgical conditions.

show abstract

Functional perfusion and blood-brain barrier permeability images in the diagnosis of cerebral tumors by angio CT

Cited by 11 publications

References 15 publications

Increased Blood–Brain Barrier Permeability on Perfusion CT Might Predict Malignant Middle Cerebral Artery Infarction

Increased Blood–Brain Barrier Permeability on Perfusion CT Might Predict Malignant Middle Cerebral Artery Infarction

Dynamic Perfusion CT Assessment of the Blood-Brain Barrier Permeability: First Pass versus Delayed Acquisition

Clinical application of perfusion computed tomography in neurosurgery

Contact Info

Product

Resources

About