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European Radiology

, Volume 17, Issue 10, pp 2491–2498 | Cite as

Perfusion CT in acute stroke: prediction of vessel recanalization and clinical outcome in intravenous thrombolytic therapy

  • Stephan P. KloskaEmail author
  • Ralf Dittrich
  • Tobias Fischer
  • Darius G. Nabavi
  • Roman Fischbach
  • Peter Seidensticker
  • Nani Osada
  • E. Bernd Ringelstein
  • Walter Heindel
Neuro

Abstract

This study evaluated perfusion computed tomography (PCT) for the prediction of vessel recanalization and clinical outcome in patients undergoing intravenous thrombolysis. Thirty-nine patients with acute ischemic stroke of the middle cerebral artery territory underwent intravenous thrombolysis within 3 h of symptom onset. They all had non-enhanced CT (NECT), PCT, and CT angiography (CTA) before treatment. The Alberta Stroke Program Early Computed Tomography (ASPECT) score was applied to NECT and PCT maps to assess the extent of ischemia. CTA was assessed for the site of vessel occlusion. The National Institute of Health Stroke Scale (NIHSS) score was used for initial clinical assessment. Three-month clinical outcome was assessed using the modified Rankin scale. Vessel recanalization was determined by follow-up ultrasound. Of the PCT maps, a cerebral blood volume (CBV) ASPECT score of >6 versus ≤6 was the best predictor for clinical outcome (odds ratio, 31.43; 95% confidence interval, 3.41–289.58; P < 0.002), and was superior to NIHSS, NECT and CTA. No significant differences in ASPECT scores were found for the prediction of vessel recanalization. ASPECT score applied to PCT maps in acute stroke patients predicts the clinical outcome of intravenous thrombolysis and is superior to both early NECT and clinical parameters.

Keywords

Stroke Computed tomography Perfusion Thrombolysis Outcome 

Notes

Acknowledgements

The study was supported by a grant from Bayer Schering Pharma, Berlin, Germany.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Stephan P. Kloska
    • 1
    Email author
  • Ralf Dittrich
    • 2
  • Tobias Fischer
    • 1
  • Darius G. Nabavi
    • 2
  • Roman Fischbach
    • 1
  • Peter Seidensticker
    • 3
  • Nani Osada
    • 4
  • E. Bernd Ringelstein
    • 2
  • Walter Heindel
    • 1
  1. 1.Department of Clinical RadiologyUniversity of MünsterMünsterGermany
  2. 2.Department of NeurologyUniversity of MünsterMünsterGermany
  3. 3.Global Medical AffairsBayer Schering Pharma AGBerlinGermany
  4. 4.Department of Medical Informatics and BiomathematicsUniversity of MünsterMünsterGermany

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