Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment
Background. Intracerebral hemorrhage (ICH) is a serious complication of endovascular treatment (EVT) in stroke patients with large vessel occlusion (LVO) and associated with increased morbidity and mortality. Aims. Identification of radiological predictors is highly relevant. We investigated the pre...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2021/9933015 |
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| author | Friederike Austein Antonia Carlotta Fischer Jens Fiehler Olav Jansen Thomas Lindner Susanne Gellißen |
| author_facet | Friederike Austein Antonia Carlotta Fischer Jens Fiehler Olav Jansen Thomas Lindner Susanne Gellißen |
| author_sort | Friederike Austein |
| collection | DOAJ |
| description | Background. Intracerebral hemorrhage (ICH) is a serious complication of endovascular treatment (EVT) in stroke patients with large vessel occlusion (LVO) and associated with increased morbidity and mortality. Aims. Identification of radiological predictors is highly relevant. We investigated the predictive power of computed tomography perfusion (CTP) parameters concerning ICH in patients receiving EVT. Methods. 392 patients with anterior circulation LVO with multimodal CT imaging who underwent EVT were analyzed. CTP parameters were visually evaluated for modified ASPECTS regions and compared between patients without ICH, those with hemorrhagic infarction (HI), and those with parenchymal hematoma (PH) according to the ECASS criteria at follow-up imaging and broken down by ASPECTS regions. Results. 168 received intravenous thrombolysis (IV-rtPA), and 115 developed subsequent ICH (29.3%), of which 74 were classified as HI and 41 as PH. Patients with HI and PH had lower ASPECTS than patients without ICH and worse functional outcome after 90 days (p<0.05). In 102 of the 115 patients with ICH, the deep middle cerebral artery (MCA) territory was affected with differences between patients without ICH, those with HI, and those with PH regarding cerebral blood volume (CBV) and blood-brain barrier permeability measured as flow extraction product (FED) relative to the contralateral hemisphere (p<0.05). Patients with PH showed larger perfusion CT infarct core than patients without ICH (p<0.01). Conclusion. None of the examined CTP parameters was found to be a strong predictor of subsequent ICH. ASPECTS and initial CTP core volume were more reliable and may be useful and even so more practicable to assess the risk of subsequent ICH after EVT. |
| format | Article |
| id | doaj-art-32bb5a4dbaa04dbabae4907e09b5f38b |
| institution | Kabale University |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-32bb5a4dbaa04dbabae4907e09b5f38b2025-02-03T01:12:54ZengWileyStroke Research and Treatment2090-81052042-00562021-01-01202110.1155/2021/99330159933015Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular TreatmentFriederike Austein0Antonia Carlotta Fischer1Jens Fiehler2Olav Jansen3Thomas Lindner4Susanne Gellißen5Department for Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, GermanyDepartment for Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, GermanyDepartment for Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment for Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyBackground. Intracerebral hemorrhage (ICH) is a serious complication of endovascular treatment (EVT) in stroke patients with large vessel occlusion (LVO) and associated with increased morbidity and mortality. Aims. Identification of radiological predictors is highly relevant. We investigated the predictive power of computed tomography perfusion (CTP) parameters concerning ICH in patients receiving EVT. Methods. 392 patients with anterior circulation LVO with multimodal CT imaging who underwent EVT were analyzed. CTP parameters were visually evaluated for modified ASPECTS regions and compared between patients without ICH, those with hemorrhagic infarction (HI), and those with parenchymal hematoma (PH) according to the ECASS criteria at follow-up imaging and broken down by ASPECTS regions. Results. 168 received intravenous thrombolysis (IV-rtPA), and 115 developed subsequent ICH (29.3%), of which 74 were classified as HI and 41 as PH. Patients with HI and PH had lower ASPECTS than patients without ICH and worse functional outcome after 90 days (p<0.05). In 102 of the 115 patients with ICH, the deep middle cerebral artery (MCA) territory was affected with differences between patients without ICH, those with HI, and those with PH regarding cerebral blood volume (CBV) and blood-brain barrier permeability measured as flow extraction product (FED) relative to the contralateral hemisphere (p<0.05). Patients with PH showed larger perfusion CT infarct core than patients without ICH (p<0.01). Conclusion. None of the examined CTP parameters was found to be a strong predictor of subsequent ICH. ASPECTS and initial CTP core volume were more reliable and may be useful and even so more practicable to assess the risk of subsequent ICH after EVT.http://dx.doi.org/10.1155/2021/9933015 |
| spellingShingle | Friederike Austein Antonia Carlotta Fischer Jens Fiehler Olav Jansen Thomas Lindner Susanne Gellißen Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment Stroke Research and Treatment |
| title | Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment |
| title_full | Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment |
| title_fullStr | Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment |
| title_full_unstemmed | Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment |
| title_short | Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment |
| title_sort | value of perfusion ct in the prediction of intracerebral hemorrhage after endovascular treatment |
| url | http://dx.doi.org/10.1155/2021/9933015 |
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