CT Perfusion ASPECTS in the Evaluation of Acute Ischemic Stroke: Thrombolytic Therapy Perspective.

Cerebrovascular Diseases Extra
Niko SillanpaaSeppo Soimakallio

Abstract

Advances in the management of acute ischemic stroke and medical imaging are creating pressure to replace the rigid one-third middle cerebral artery (MCA) and non-contrast-enhanced CT (NCCT) Alberta Stroke Program Early CT Score (ASPECTS) thresholds used for the selection of patients eligible for intravenous thrombolytic therapy. The identification of potentially salvageable ischemic brain tissue lies at the core of this issue. In this study, the role of CT perfusion ASPECTS in the detection of reversible ischemia was analyzed. We retrospectively reviewed the clinical and imaging data of 92 consecutive patients who received intravenous thrombolytic therapy for acute (duration <3 h) ischemic stroke. Most of the patients underwent admission multimodal CT, and all patients had follow-up NCCT at 24 h. ASPECTS was assigned to all modalities and correlated with clinical and imaging parameters. Receiver-operating characteristic curve analysis was performed to determine optimal thresholds for different parameters to predict clinical outcome. A perfusion defect could be detected in 50% of the patients. ASPECTS correlated inversely with the clinical outcome in the following order: follow-up NCCT > cerebral blood volume (CBV) > mean transi...Continue Reading

Citations

Mar 16, 2012·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·J T SaarinenI Elovaara
Aug 27, 2014·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Jukka T SaarinenIrina Elovaara
May 31, 2014·AJNR. American Journal of Neuroradiology·J T SaarinenN Sillanpää
Mar 5, 2016·Cardiovascular and Interventional Radiology·Sara ProttoHeikki Numminen
Jun 12, 2014·Journal of Neurointerventional Surgery·Alejandro M SpiottaAquilla S Turk
Sep 13, 2016·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Milan HromádkaRichard Rokyta
Jun 12, 2014·Stroke; a Journal of Cerebral Circulation·Vladimir RohanJiri Ferda
Aug 29, 2020·Neuroradiology·Frans KauwUNKNOWN Dutch acute stroke study (DUST) investigators
Jan 28, 2017·Frontiers in Neurology·Julian Schröder, Götz Thomalla
Oct 1, 2019·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Adnan I QureshiShawn S Wallery
Nov 10, 2017·Interventional Neurology·Niko SillanpääHarri Rusanen
Dec 13, 2016·Cardiovascular and Interventional Radiology·Sara ProttoNiko Sillanpää

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Software Mentioned

ASPECTS
SPSS
CTP ASPECTS
CT Perfusion
Advantage Workstation

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