Additional diagnostic value of computed tomography perfusion for detection of acute ischemic stroke in the posterior circulation

Stroke; a Journal of Cerebral Circulation
Erik J R J van der HoevenDust Investigators

Abstract

Detection of acute infarction in the posterior circulation is challenging. We aimed to determine the additional value of tomograpy (CT) perfusion to noncontrast CT and CT angiography source images for infarct detection and localization in patients suspected of acute ischemic posterior circulation stroke. Patients with suspected acute ischemic posterior circulation stroke were selected from the Dutch acute Stroke Trial (DUST) study. Patients underwent noncontrast CT, CT angiography, and CT perfusion within 9 hours after stroke onset and CT or MRI on follow-up. Images were evaluated for signs and location of ischemia. Discrimination of 3 hierarchical logistic regression models (noncontrast CT [A], added CT angiography source images [B], and CT perfusion [C]) was compared with C-statistics. Of 88 patients, 76 (86%) had a clinical diagnosis of ischemic stroke on discharge and 42 patients (48%) showed a posterior circulation infarct on follow-up imaging. Model C (area under the curve from the receiver operating characteristic curve=0.86; 95% confidence interval, 0.77-0.94) predicted an infarct in the posterior circulation territory better than models A (area under the curve from the receiver operating characteristic curve=0.64; 95% ...Continue Reading

References

Jul 12, 2008·Stroke; a Journal of Cerebral Circulation·Volker PuetzAndrew M Demchuk
Jun 9, 2012·Stroke; a Journal of Cerebral Circulation·Wen-Dan TaoBo Wu

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Citations

Sep 22, 2016·Neuroradiology·Christine BollweinLouisa von Baumgarten
Jan 20, 2018·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·L-P PallesenP Michel
Nov 22, 2017·International Journal of Stroke : Official Journal of the International Stroke Society·Fana AlemsegedBruce Cv Campbell
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Jan 15, 2021·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Adam E Goldman-YassenSeena Dehkharghani
Feb 17, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Paola CarusoPaolo Manganotti
May 6, 2021·Stroke; a Journal of Cerebral Circulation·Matthias P FabritiusPaul Reidler
May 23, 2021·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Anubhav KatyalSonu Menachem Maimonides Bhaskar
Sep 28, 2021·Stroke; a Journal of Cerebral Circulation·Manal Nicolas-Jilwan, Max Wintermark
Sep 29, 2021·International Journal of Stroke : Official Journal of the International Stroke Society·Alexander SalernoPatrik Michel
Aug 19, 2016·Neurology·Hendrikus J A van OsMarieke J H Wermer

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