Perfusion computed tomography relative threshold values in definition of acute stroke lesions

Radziņa, Maija; Krumina, Gaida; Kupčs, Kārlis; Miglāne, Evija

doi:10.1177/2047981613486099

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…All patients received multimodal computed tomography (CT) imaging including non-contrast CT, CT angiography of intra-and extracranial blood vessels, and CT perfusion (CTP). Imaging equipment used were GE LightSpeed VCT 64 scanner and AW CT Perfusion 4D post-processing software (13,14) (GE Healthcare, USA). CTP was performed for tissue viability assessment and for differentiation of ''core'' area describing irreversible cerebral ischemia or necrosis from ''penumbra'' showed as hypoperfused brain tissue, also called tissue at risk (13).…”

Section: Methodsmentioning

confidence: 99%

Endovascular thrombectomy in anterior circulation stroke and clinical value of bridging with intravenous thrombolysis

et al. 2018

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Background Bridging treatment with intravenous thrombolysis (IVT) before endovascular thrombectomy (EVT) in acute ischemic stroke is applied under the assumption of benefits for patients with large vessel occlusion (LVO). However, the benefit of this additional step has not yet been proven. Purpose To compare procedural parameters (procedural time, number of attempts), complications, and clinical outcome in patients receiving EVT vs. patients with bridging treatment. Material and Methods In this prospective study all patients had acute anterior cerebral circulation occlusion and were treated with EVT. All patients were selected for treatment based on clinical criteria, multimodal computed tomography (CT) imaging. Eighty-four patients were treated with bridging IVT followed by EVT; 62 patients were treated with EVT only. Results Bridging therapy did not influence endovascular procedure time ( P = 0.71) or number of attempts needed ( P = 0.63). Bleeding from any site was more common in the bridging group (27, 32%) vs. the EVT group (12, 19%) ( P = 0.09). Functional independence modified Rankin Scale after 90 days was slightly higher in the bridging group (44%) vs. the EVT group (42%) ( P = 0.14). Mortality did not differ significantly at 90 days: 17% in the bridging group vs. 21% in EVT alone ( P = 0.57). Both treatment methods showed high recanalization rates: 94% in the bridging group and 89% for EVT alone. Conclusion Bridging treatment in LVO did not show benefits or elevated risks of complications in comparison to EVT only. The bridging group did not show significantly better neurological outcome or significant impact on procedural parameters vs. EVT alone.

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Section: Methodsmentioning

confidence: 99%

Endovascular thrombectomy in anterior circulation stroke and clinical value of bridging with intravenous thrombolysis

et al. 2018

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“…The threshold chosen in this paper is 0.4, i.e. 60% relative flow rate compared with a healthy simulation [36][37][38][39]. This threshold is commonly used to estimate the penumbra i.e.…”

Section: One-dimensional Blood Flow Modellingmentioning

confidence: 99%

Modelling collateral flow and thrombus permeability during acute ischaemic stroke

Padmos

Terreros

Józsa

et al. 2022

J. R. Soc. Interface.

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The presence of collaterals and high thrombus permeability are associated with good functional outcomes after an acute ischaemic stroke. We aim to understand the combined effect of the collaterals and thrombus permeability on cerebral blood flow during an acute ischaemic stroke. A cerebral blood flow model including the leptomeningeal collateral circulation is used to simulate cerebral blood flow during an acute ischaemic stroke. The collateral circulation is varied to capture the collateral scores: absent, poor, moderate and good. Measurements of the transit time, void fraction and thrombus length in acute ischaemic stroke patients are used to estimate thrombus permeability. Estimated thrombus permeability ranges between 10 −7 and 10 −4 mm 2 . Measured flow rates through the thrombus are small and the effect of a permeable thrombus on brain perfusion during stroke is small compared with the effect of collaterals. Our simulations suggest that the collaterals are a dominant factor in the resulting infarct volume after a stroke.

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“…7 Perfusion mapping can then be derived based on TDC graphs, providing visual information about perfusion deficits in the ischemic area. 9 The perfusion parameters that can be obtained by mapping include cerebral blood volume (CBV), cerebral blood flow (CBF), time to peak of tissue enhancement (TTP), mean transit time (MTT), and time-to-maximum of the residual function (Tmax), all of which indirectly reflect hemodynamic changes in blood flow.…”

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confidence: 99%

Optimal injection rate and catheter size for brain perfusion computed tomography using non-ionic contrast medium in clinically normal Beagles

Choi

Kim

et al. 2023

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OBJECTIVE To evaluate the effects of contrast medium injection rates and intravenous injection catheter sizes on the time-density curve (TDC) of brain perfusion computed tomography (PCT) images in clinically normal Beagles and provide a reference range for the perfusion parameters for clinical application of PCT in veterinary medicine. ANIMALS 5 healthy, sexually intact male Beagles. PROCEDURES All dogs underwent general anesthesia for PCT. Contrast medium (350 mg I/kg) was injected at 3 different injection rates (2, 3, and 4 mL/second) and with 2 sizes of an intravenous catheter (20-gauge and 24-gauge). The rostral cerebral artery and dorsal sagittal sinus were selected as the regions of interest of the TDC. Initiation time of arterial inflow (ta), venous outflow (tv), peak time of arterial enhancement (Tap), and the peak time of venous enhancement (Tvp), were measured, and the difference between Tap and tv (Tap-tv) and between Tap and ta (Tap-ta) was calculated. RESULTS Both Tap-tv and Tap-ta were significantly (P < .05) shorter at the rate of 3 mL/second than at 2 mL/second with the 24-gauge catheter. However, there was no significant difference according to catheter sizes. Particularly, a 4 mL/second injection rate using a 24-gauge catheter mostly resulted in contrast medium leakage and catheter rupture. CLINICAL RELEVANCE: CONTRAST MEDIUM INJECTION At a rate of 3 mL/second and with a 24-gauge catheter ensures optimal image acquisition and stable contrast medium injection in brain PCT for small dogs. PCT may be useful for diagnosing cerebrovascular events and hemodynamic changes in small dogs.

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Perfusion computed tomography relative threshold values in definition of acute stroke lesions

Cited by 9 publications

References 5 publications

Endovascular thrombectomy in anterior circulation stroke and clinical value of bridging with intravenous thrombolysis

Endovascular thrombectomy in anterior circulation stroke and clinical value of bridging with intravenous thrombolysis

Modelling collateral flow and thrombus permeability during acute ischaemic stroke

Optimal injection rate and catheter size for brain perfusion computed tomography using non-ionic contrast medium in clinically normal Beagles

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