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Neuroradiology

, Volume 44, Issue 4, pp 286–293 | Cite as

Semiquantitative dynamic computed tomography to predict response to anti-platelet therapy in acute cerebral infarction

  • K. Chokyu
  • M. Fukumoto
  • T. Mori
  • T. Mokudai
  • K. Mori
  • K. Shimizu
Diagnostic Neuroradiology
  • 59 Downloads

Abstract.

We investigated whether dynamic computed tomography (CT) in patients with acute cerebral infarction could identify patients likely to respond to anti-platelet therapy. Seventy patients underwent semiquantitative dynamic CT within 6 h as well as cerebral angiography. All then received anti-platelet therapy with a thromboxane A2 synthetase inhibitor. Peak value (pv) and time-to-peak (tp) (time–density curves) for the Sylvian fissure were extracted from dynamic CT data and standardizing interpatient data, two indices, PV/TP index and TP index, were prepared following a standard semiquantitative manner. Both PV/TP index and TP index were effective in discriminating between 48 responders (modified Rankin scale (mRS): 0 to 2) and 22 non-responders (mRS: 3 to 5, or death: 6; both P<0.0001). High PV/TP index (≥0.8) was a strong indicator of favorable response. Most of these patients maintained regional cerebral blood flow (rCBF) via anterograde flow or collaterals, with a TP index ≤1.1. Low PV/TP index (≤0.4) predicted non-response associated with increased TP index (>1.1) and non-compensated rCBF. Intermediate PV/TP values could not predict outcome. Dynamic CT prior to therapy can identify patients with acute cerebral infarction who are treatable with anti-platelet therapy alone.

Anti-platelet therapy Therapeutic response Acute cerebral infarction Stroke Dynamic computed tomography 

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Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • K. Chokyu
    • 1
  • M. Fukumoto
    • 2
  • T. Mori
    • 3
  • T. Mokudai
    • 4
  • K. Mori
    • 4
  • K. Shimizu
    • 1
  1. 1.Department of Neurosurgery, Kochi Medical School, Kohasu, Okou, Nankoku, Kochi 783-8505, JapanJapan
  2. 2.Department of Radiology, Kochi Medical School, Kochi, JapanJapan
  3. 3.Department of Stroke Treatment, Shonan Kamakura General Hospital, Kanagawa, JapanJapan
  4. 4.Mominoki Hospital, Kochi, JapanJapan

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