Value of 4D CT Angiography Combined with Whole Brain CT Perfusion Imaging Feature Analysis under Deep Learning in Imaging Examination of Acute Ischemic Stroke

Tao, Jingshan; Cai, Yong; Dai, Yisheng; Xie, Yingdi; Liu, Hailing; Zang, Xiaojin

doi:10.1155/2022/2286413

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…Similarly, TTP is defined as the time duration from the beginning of injection of contrast media to reaching the peak concentration in the ROI. The prolonged TTP is mainly caused by the slow blood flow or collateral blood supply (Tao et al., 2022 ; Yang et al., 2022 ). Comprehensive analysis of these parameters contributes to an in‐depth insight into the blood supply in brain tissues.…”

Section: Discussionmentioning

confidence: 99%

White matter hyperintensities had a correlation with the cerebral perfusion level, but no correlation with the severity of large vessel stenosis in the anterior circulation

et al. 2023

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Objective The contribution of large vessel stenosis to the development of white matter hyperintensities (WMHs) has not been fully elucidated. This study aims to explore the correlation between ipsilateral white matter hyperintensities (WMHs) and the severity of large vessel stenosis in the anterior circulation and cerebral perfusion level, as well as analyze the factors influencing WMHs. Methods A cross‐sectional study of 150 patients with unilateral anterior circulation large vessel stenosis of ≥50% was conducted. The severity of ipsilateral WMHs was assessed by Fazekas scale on T2‐weighted image and/or fluid‐attenuated inversion recovery MR imaging, vascular stenosis severity was evaluated on computed tomography angiography images, and the level of cerebral perfusion was rated according to a staging system for abnormal cerebral perfusion based on CTP results. The relationships between the stenosis severity, cerebral perfusion level and ipsilateral WMHs severity were analyzed. A multivariate logistic regression analysis was performed to determine the factors independently influencing WMHs. Results Among 150 patients (mean age, 63.12 ± 10.55 years), there was a statistically significant positive correlation between cerebral perfusion level and the severity of DWMHs and PWMHs (Gamma = 0.561, p < .001; Gamma = 0.600, p < .001), and a positive correlation between cerebral perfusion level and the severity of vascular stenosis (Gamma = 0.495, p < .001).While, there was no statistically significant correlation between the severity of vascular stenosis and the severity of DWMHs and PWMHs (Gamma = 0.188, p = .08; Gamma = 0.196, p = .06). The multivariate logistic regression analysis results demonstrated that age (OR = 1.047, 95% CI 1.003–1.093; p = .035), stroke/TIA history (OR = 2.880, 95% CI 1.154–7.190; p = .023) and stage II of cerebral perfusion (OR = 2.880, 95% CI 1.154–7.190; p = .023) were independent influencing factors on ipsilateral DWMHs. Age (OR = 1.051, 95% CI 1.009–1.094; p = .018), and stage II of cerebral perfusion (OR = 12.871, 95% CI 3.576‐46.322; p < .001) were factors independently influencing ipsilateral PWMHs. Conclusion White matter hyperintensities may be attributed to cerebral hypoperfusion secondary to vascular stenosis but not directly to the severity of stenosis in the large vessels of anterior circulation. Moreover, longitudinal studies with sequential imaging exams may further reveal the impact of cerebral perfusion secondary to vascular stenosis on the development and progression of WMHs.

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Section: Discussionmentioning

confidence: 99%

White matter hyperintensities had a correlation with the cerebral perfusion level, but no correlation with the severity of large vessel stenosis in the anterior circulation

et al. 2023

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“…A threshold delay time >3 s was used for volumetric measurement of the hypoperfusion area and relative cerebral blood flow <30% was used for calculating ischemic core volume. 12 Intracranial CT angiography clot burden score (CBS)…”

Section: Imagingmentioning

confidence: 99%

“…Among the total, 70 (37.6%) were men. The median (range) age was 71 (58-80) years and the median (IQR) NIHSS score at baseline was 15 (11)(12)(13)(14)(15)(16)(17)(18)(19). In total, 153 patients (74.6%) were identified as having AoAC and 142 (69.3%) as having CaSC.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Precranial artery calcification burden: a potential indicator of the clinical outcome of reperfusion in patients with acute large artery occlusion

Cai,

Zhou,

Wang

et al. 2024

J Int Med Res

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Objective With mechanical thrombectomy (MT), we investigated the prognostic importance of aortic arch calcification (AoAC) and carotid sinus calcification (CaSC) for symptomatic intracerebral hemorrhage (sICH) and poor outcome in acute large artery occlusion (LAO). Methods In this retrospective observational study, we calculated pre-cranial artery calcification burden (PACB) scores (burden score of AoAC and CaSC) using the AoAC grading scale score plus Woodcock visual score. The outcome measure was sICH per the European Cooperative Acute Stroke Study III definition. A 3-month modified Rankin scale score 3–6 was designated as poor outcome. Results Compared with patients who had PACB <3, those with PACB ≥3 showed substantially higher risks of sICH (odds ratio [OR] = 2.567, 95% confidence interval [CI] = 1.187–5.550) and poor outcome (OR = 4.777, 95% CI = 1.659–13.756). According to receiver operating characteristic (ROC) curves, adding PACB to the regression model enhanced the predictive value for poor outcome (area under the ROC curve [AUC]: 0.718 vs. 0.519, Z = 2.340) and in patients receiving MT (AUC: 0.714 vs. 0.584, Z = 2.021), independently. Conclusions Factors related to PACB were consistent with common risk factors of systemic atherosclerosis. Low PACB scores indicated better prognosis. In patients with LAO following MT, PACB was useful in predicting sICH and poor clinical outcome.

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“…The best information on the age of ischaemic lesions and the amount of tissue that can be saved comes from MRI. 10 The thrombolysis trials conducted on patients in previous research using the MRI image-based analysis, however, were not particularly successful. Although MRI may give a general picture of how a stroke is progressing, it is highly advised frequently to understand the mechanics underlying stroke creation and weigh the risks and benefits depending on many clinical factors.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Analysis of Diagnostic Imaging in Acute Ischaemic Stroke

Kaur

2023

CHCMJ

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Acute ischaemic stroke (AIS) is responsible for almost 90% of all strokes. Large vessel occlusion is mainly responsible for AIS. Earlier treatment of AIS is associated with improved outcomes. Multimodal imaging methods such as MRI and CT provide information that can help in diagnosing it. These methods are helpful in the prognosis of AIS and in the selection of patients who can be subjected to thrombolytic therapy. Objectives of the Study:The present comparative study has been conducted to understand whether MRI images are better for the diagnosis of AIS than CT, to assess the efficacy of tPA in the recovery of patients, and to explore the role of advanced imaging in acute stroke.Methods: The present study was conducted with 40 patients, aged 18 years and above who presented to the Emergency Department of Uppal Neuro Hospital, Amritsar, Punjab with a history of acute ischaemic stroke or hyperacute stroke between September 2017 and March 2018. All patients were examined using 32 slices CT and 1.5T MRI scanner. Among all cases, 17 patients had suffered a hyperacute stroke and 23 had suffered an acute ischaemic stroke.Results: It was observed that AIS-associated changes are detectable sooner with MRI as compared to CT. MRI has a higher interobserver and intraobserver reliability as seen with diffusion-weighted imaging MRI as compared to CT in the diagnosis of AIS. Patients who were treated with tPA were found to recover quickly as compared to those who were not treated with tPA.Conclusion: Sophisticated techniques such as perfusion imaging and non-invasive vascular imaging are becoming more effective tools for guiding prospective endovascular treatment or extending therapy windows in the case of patients with acute ischaemic stroke.

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Value of 4D CT Angiography Combined with Whole Brain CT Perfusion Imaging Feature Analysis under Deep Learning in Imaging Examination of Acute Ischemic Stroke

Cited by 5 publications

References 26 publications

White matter hyperintensities had a correlation with the cerebral perfusion level, but no correlation with the severity of large vessel stenosis in the anterior circulation

White matter hyperintensities had a correlation with the cerebral perfusion level, but no correlation with the severity of large vessel stenosis in the anterior circulation

Precranial artery calcification burden: a potential indicator of the clinical outcome of reperfusion in patients with acute large artery occlusion

A Comparative Analysis of Diagnostic Imaging in Acute Ischaemic Stroke

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