Diagnosing acute lacunar infarction using CT perfusion

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
Wenjie CaoBruce C V Campbell

Abstract

The value of CT perfusion (CTP) in detecting acute lacunar infarcts (LACI) has not been well established. We tested the sensitivity of CTP for LACI. CTP maps of consecutive stroke patients from 2009-2013 were examined. MRI diffusion imaging was used to identify those with LACI. Two stroke neurologists independently evaluated the CTP maps for evidence of a perfusion lesion in a deep perforating artery territory. Cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to maximum (Tmax) maps were first examined in isolation and then in combination. Inter-observer agreement was measured using Cohen's κ. The lesions identified were later confirmed against the diffusion MRI reference and the sensitivity and specificity of CTP maps calculated. A total of 63 patient scans were analysed. There were 32 patients with MRI-confirmed LACI within the coverage of CTP; 18 in the striatum, 10 thalamic, and four in the corona radiata. Another 31 patients had normal MRI. Inter-rater agreement was good (κ=0.83). Sensitivity (blinded consensus) was highest for MTT (56.2%) compared to Tmax (25%, p<0.001), CBV (9.3%, p=0.021) and CBF (43.7%, p<0.001). MTT maps enable detection of a significant proportion of LACI using ...Continue Reading

References

Jun 15, 2007·Cerebrovascular Diseases·Jan Lodder
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Sep 2, 2011·Neurology·Sebastian KochRita Bhatia
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Jan 29, 2013·Journal of Neurology, Neurosurgery, and Psychiatry·Bruce C V CampbellStephen M Davis

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Citations

Aug 20, 2016·AJNR. American Journal of Neuroradiology·J C BensonA M McKinney
Mar 16, 2018·International Journal of Stroke : Official Journal of the International Stroke Society·Bruce Cv Campbell, Mark W Parsons
Feb 14, 2018·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Salvatore RudilossoXabier Urra
Jun 23, 2020·Stroke; a Journal of Cerebral Circulation·Bruce C V Campbell
Feb 6, 2020·Stroke; a Journal of Cerebral Circulation·Jelle DemeestereMaarten G Lansberg
Oct 22, 2020·Stroke; a Journal of Cerebral Circulation·Bruce C V Campbell
Dec 29, 2020·Stroke; a Journal of Cerebral Circulation·Carlos Garcia-EsperonMark W Parsons
Aug 27, 2021·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Lan HongQiang Dong
Aug 28, 2021·Journal of Clinical Medicine·Rajeel ImranFadi Nahab
Nov 21, 2021·Current Opinion in Neurology·Klearchos Psychogios, Georgios Tsivgoulis

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