Impact of Intracranial Volume and Brain Volume on the Prognostic Value of Computed Tomography Perfusion Core Volume in Acute Ischemic Stroke.

Autor: Hoving JW; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., Konduri PR; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., Tolhuisen ML; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., Koopman MS; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., van Voorst H; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., Van Poppel LM; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., Daems JD; Department of Public Health, Erasmus University Medical Center, P.O. Box 2040 Rotterdam, The Netherlands.; Department of Neurology, Erasmus University Medical Center, P.O. Box 2040 Rotterdam, The Netherlands., van Es ACGM; Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands., van Walderveen MAA; Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands., Lingsma HF; Department of Neurology, Erasmus University Medical Center, P.O. Box 2040 Rotterdam, The Netherlands., Dippel DWJ; Department of Neurology, Erasmus University Medical Center, P.O. Box 2040 Rotterdam, The Netherlands., Van Zwam WH; Department of Radiology and Nuclear Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, 6202 AZ Maastricht, The Netherlands., Marquering HA; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., Majoie CBLM; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., Emmer BJ; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Journal of cardiovascular development and disease [J Cardiovasc Dev Dis] 2024 Feb 28; Vol. 11 (3). Date of Electronic Publication: 2024 Feb 28.
DOI: 10.3390/jcdd11030080
Abstrakt: Background: Computed tomography perfusion (CTP)-estimated core volume is associated with functional outcomes in acute ischemic stroke. This relationship might differ among patients, depending on brain volume.
Materials and Methods: We retrospectively included patients from the MR CLEAN Registry. Cerebrospinal fluid (CSF) and intracranial volume (ICV) were automatically segmented on NCCT. We defined the proportion of the ICV and total brain volume (TBV) affected by the ischemic core as ICV core and TBV core . Associations between the core volume, ICV core , TBV core , and functional outcome are reported per interquartile range (IQR). We calculated the area under the curve (AUC) to assess diagnostic accuracy.
Results: In 200 patients, the median core volume was 13 (5-41) mL. Median ICV and TBV were 1377 (1283-1456) mL and 1108 (1020-1197) mL. Median ICV core and TBV core were 0.9 (0.4-2.8)% and 1.7 (0.5-3.6)%. Core volume (acOR per IQR 0.48 [95%CI 0.33-0.69]), ICV core (acOR per IQR 0.50 [95%CI 0.35-0.69]), and TBV core (acOR per IQR 0.41 95%CI 0.33-0.67]) showed a lower likelihood of achieving improved functional outcomes after 90 days. The AUC was 0.80 for the prediction of functional independence at 90 days for the CTP-estimated core volume, the ICV core , and the TBV core .
Conclusion: Correcting the CTP-estimated core volume for the intracranial or total brain volume did not improve the association with functional outcomes in patients who underwent EVT.
Databáze: MEDLINE
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