- Title
- Optimal Delay Time of CT Perfusion for Predicting Cerebral Parenchymal Hematoma After Intra-Arterial tPA Treatment
- Creator
- Wu, Bing; Liu, Nan; Li, Ying; Su, Zihua; Wu, Xinhuai; Zhu, Guangming; Wintermark, Max; Parsons, Mark W.; Chen, Hui; Lin, Longting; Zhou, Shuai; Hui, Gang; Zhang, Yongwei; Hui, Jun
- Relation
- Frontiers in Neurology Vol. 9, Issue 21 August 2018, no. 680
- Publisher Link
- http://dx.doi.org/10.3389/fneur.2018.00680
- Publisher
- Frontiers Research Foundation
- Resource Type
- journal article
- Date
- 2018
- Description
- Background and Purpose: Cerebral hemorrhage is a serious potential complication of stroke revascularization, especially in patients receiving intra-arterial tissue-type plasminogen activator (tPA) therapy. We investigated the optimal pre-intervention delay time (DT) of computed tomography perfusion (CTP) measurement to predict cerebral parenchymal hematoma (PH) in acute ischemic stroke (AIS) patients after intra-arterial tissue plasminogen activator (tPA) treatment. Methods: The study population consisted of a series of patients with AIS who received intra-arterial tPA treatment and had CTP and follow-up computed tomography/magnetic resonance imaging (CT/MRI) to identify hemorrhagic transformation. The association of increasing DT thresholds (>2, >4, >6, >8, and >10 s) with PH was examined using receiver operating characteristic (ROC) analysis and logistic regression. Results: Of 94 patients, 23 developed PH on follow-up imaging. Receiver operating characteristic analysis revealed that the greatest area under the curve for predicting PH occurred at DT > 4 s (area under the curve, 0.66). At this threshold of > 4 s, DT lesion volume ≥ 30.85 mL optimally predicted PH with 70% sensitivity and 59% specificity. DT > 4 s volume was independently predictive of PH in a multivariate logistic regression model (P < 0.05). Conclusions: DT > 4 s was the parameter most strongly associated with PH. The volume of moderate, not severe, hypo-perfusion on DT is more strongly associated and may allow better prediction of PH after intra-arterial tPA thrombolysis.
- Subject
- stroke; hemorrhage transformation; CT scan; perfusion imaging; delay time; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1448177
- Identifier
- uon:43334
- Identifier
- ISSN:1664-2295
- Language
- eng
- Reviewed
- Hits: 3885
- Visitors: 3870
- Downloads: 0