Early detection of small volume stroke and thromboembolic sources with computed tomography: Rationale and design of the ENCLOSE study.

Autor:	Kauw F; Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.; Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands., van Ommen F; Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Bennink E; Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.; Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Cramer MJ; Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht, Utrecht University, The Netherlands., Kappelle LJ; Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands., Takx RA; Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Velthuis BK; Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Viergever MA; Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.; Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Wouter van Es H; Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Schonewille WJ; Department of Radiology, St. Antonius Hospital, Nieuwegein, The Netherlands., Coutinho JM; Department of Neurology, St. Antonius Hospital, Nieuwegein, The Netherlands., Majoie CB; Department of Neurology, Amsterdam UMC, Amsterdam, The Netherlands., Marquering HA; Department of Neurology, Amsterdam UMC, Amsterdam, The Netherlands.; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, The Netherlands., de Jong HW; Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Dankbaar JW; Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	European stroke journal [Eur Stroke J] 2020 Dec; Vol. 5 (4), pp. 432-440. Date of Electronic Publication: 2020 Oct 23.
DOI:	10.1177/2396987320966420
Abstrakt:	Background: Computed tomography is the most frequently used imaging modality in acute stroke imaging protocols. Detection of small volume infarcts in the brain and cardioembolic sources of stroke is difficult with current computed tomography protocols. Furthermore, the role of computed tomography findings to predict recurrent ischemic stroke is unclear. With ENCLOSE, we aim to improve (1) the detection of small volume infarcts with thin slice computed tomography perfusion (CTP) images and thromboembolic source with cardiac computed tomography techniques in the acute stage of ischemic stroke and (2) prediction of recurrent ischemic stroke with computed tomography-derived predictors.Methods/design: ENCLOSE is a prospective multicenter observational cohort study, which will be conducted in three Dutch stroke centers (ClinicalTrials.gov Identifier: NCT04019483). Patients (≥18 years) with suspected acute ischemic stroke who undergo computed tomography imaging within 9 h after symptom onset are eligible. Computed tomography imaging includes non-contrast CT, CTP, and computed tomography angiography (CTA) from base of the heart to the top of the brain. Dual-energy CT data will be acquired when possible, and thin-slice CTP reconstructions will be obtained in addition to standard 5 mm CTP data. CTP data will be processed with commercially available software and locally developed model-based methods. The post-processed thin-slice CTP images will be compared to the standard CTP images and to magnetic resonance diffusion-weighted imaging performed within 48 h after admission. Detection of cardioembolic sources of stroke will be evaluated on the CTA images. Recurrence will be evaluated 90 days and two years after the index event. The added value of imaging findings to prognostic models for recurrent ischemic stroke will be evaluated. Conclusion: The aim of ENCLOSE is to improve early detection of small volume stroke and thromboembolic sources and to improve prediction of recurrence in patients with acute ischemic stroke. Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© European Stroke Organisation 2020.)
Databáze:	MEDLINE
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