CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circulation stroke

Neuroradiology
Tom van SeetersDutch acute stroke study (DUST) investigators

Abstract

We investigated whether baseline CT angiography (CTA) and CT perfusion (CTP) in acute ischemic stroke could improve prediction of infarct presence and infarct volume on follow-up imaging. We analyzed 906 patients with suspected anterior circulation stroke from the prospective multicenter Dutch acute stroke study (DUST). All patients underwent baseline non-contrast CT, CTA, and CTP and follow-up non-contrast CT/MRI after 3 days. Multivariable regression models were developed including patient characteristics and non-contrast CT, and subsequently, CTA and CTP measures were added. The increase in area under the curve (AUC) and R (2) was assessed to determine the additional value of CTA and CTP. At follow-up, 612 patients (67.5%) had a detectable infarct on CT/MRI; median infarct volume was 14.8 mL (interquartile range (IQR) 2.8-69.6). Regarding infarct presence, the AUC of 0.82 (95% confidence interval (CI) 0.79-0.85) for patient characteristics and non-contrast CT was improved with addition of CTA measures (AUC 0.85 (95% CI 0.82-0.87); p < 0.001) and was even higher after addition of CTP measures (AUC 0.89 (95% CI 0.87-0.91); p < 0.001) and combined CTA/CTP measures (AUC 0.89 (95% CI 0.87-0.91); p < 0.001). For infarct volume, ad...Continue Reading

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Citations

Oct 21, 2016·Neuroradiology·Tom van SeetersUNKNOWN Dutch acute stroke study (DUST) investigators
May 19, 2017·Topics in Magnetic Resonance Imaging : TMRI·Pradeep KrishnanRichard I Aviv
Oct 22, 2019·Journal of the American Heart Association·Matthias P FabritiusWolfgang G Kunz
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May 28, 2019·International Journal of Stroke : Official Journal of the International Stroke Society·Inge A MulderUNKNOWN DUST investigators
Dec 3, 2016·BMC Neurology·Marjolein GeurtsUNKNOWN DUST investigators
Feb 6, 2019·Neuroradiology·Anna KoopmanFrederick Meijer
Sep 25, 2019·Stroke; a Journal of Cerebral Circulation·Sunil A ShethLuca Giancardo
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Nov 26, 2020·Brain Sciences·Tommaso VerdolottiCesare Colosimo
May 6, 2021·Stroke; a Journal of Cerebral Circulation·Matthias P FabritiusPaul Reidler

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