Breuer L, Knott M, Struffert T, Kloska S, Kurka N, Schwab S, Dörfler A, Köhrmann M, Engelhorn T (2015)
Publication Type: Journal article
Publication year: 2015
Book Volume: 24
Pages Range: 2491-6
Journal Issue: 11
DOI: 10.1016/j.jstrokecerebrovasdis.2015.06.017
Perfusion computed tomography (PCT) has emerged as alternative to magnetic resonance imaging (MRI) for assessment of patients clinically qualifying for off-label thrombolysis within 4.5 to 9 hours after onset of ischemic stroke. However, disadvantage of PCT is its often limited anatomic coverage with only 2 or 3 slices when using a 4- to 64-section scanner. Our purpose was therefore to evaluate the value of 2- and 3-slice perfusion compared to whole-brain perfusion.One hundred twenty-five patients undergoing MRI beyond 4.5 hours after symptom onset with supratentorial perfusion deficit were selected retrospectively. Accordingly to PCT slice positioning, 2 or 3 slices of the whole-brain perfusion weighted imaging data set were depicted. Volumes of infarct (using cerebral blood volume) and penumbra (using time-to-peak and cerebral blood volume) were calculated, and results were compared with 2- and 3-slice-derived volumes, respectively.Whole-brain imaging revealed a mismatch of more than 20% in 68.8% of patients (defined as 100%). Two-slice imaging detected a perfusion deficit in 72% and a mismatch in 48.8% (sensitivity = 70.9%). Three-slice imaging detected a perfusion deficit in 76% and a mismatch in 50.4% (sensitivity = 73.3%). Although there was no significant difference between 2- and 3-slice imaging (P > .23), both techniques revealed significantly less patients with mismatch compared to whole-brain coverage (P < .01).Two- and 3-slice imaging like obtained with PCT on most installed CT systems to assess perfusion deficits with subsequent mismatch calculation in acute stroke outside the 4.5-hour time window is significantly inferior to whole-brain coverage and, hence, has to be considered as a less-than-ideal solution.
APA:
Breuer, L., Knott, M., Struffert, T., Kloska, S., Kurka, N., Schwab, S.,... Engelhorn, T. (2015). Limited versus Whole-Brain Perfusion for the Indication of Thrombolysis in the Extended Time Window of Acute Cerebral Ischemia. Journal of Stroke and Cerebrovascular Diseases, 24(11), 2491-6. https://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2015.06.017
MLA:
Breuer, Lorenz, et al. "Limited versus Whole-Brain Perfusion for the Indication of Thrombolysis in the Extended Time Window of Acute Cerebral Ischemia." Journal of Stroke and Cerebrovascular Diseases 24.11 (2015): 2491-6.
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