CT perfusion derived relative cerebral blood volume < 42 % is negatively associated with poor functional outcomes at discharge in anterior circulation large vessel occlusion stroke.

Autor: Lakhani DA; Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA. Electronic address: dhairyalakhani@gmail.com., Balar AB; Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA., Vagal V; Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA., Salim H; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Mei J; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Koneru M; Cooper Medical School of Rowan University, Camden, NJ, USA., Wen S; Department of Biostatistics, West Virginia University, Morgantown, WV, USA., Berksu Ozkara B; Department of Neuroradiology, MD Anderson Medical Center, Houston, TX, USA., Lu H; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Wang R; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Xu R; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Nabi M; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Mazumdar I; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Cho A; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Chen K; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Sepehri S; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Deng F; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Hyson N; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Urrutia V; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Luna LP; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA., Sriwastwa A; Department of Radiology, University of Cincinnati, Cincinnati, OH, USA., Hillis AE; Department of Neurology, Johns Hopkins University, Baltimore, MD, USA., Heit JJ; Department of Radiology, Stanford University, Stanford, CA, USA., Albers GW; Department of Radiology, Stanford University, Stanford, CA, USA., Rai AT; Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA., Dmytriw AA; Department of Radiology, Harvard Medical School, Boston, MA, USA., Faizy TD; Department of Radiology, Neuroendovascular Division, University Medical Center Münster, Germany., Wintermark M; Department of Neuroradiology, MD Anderson Medical Center, Houston, TX, USA., Nael K; Division of Neuroradiology, University of California San Francisco, CA, USA., Yedavalli VS; The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA.
Jazyk: angličtina
Zdroj: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2024 Nov 12; Vol. 130, pp. 110907. Date of Electronic Publication: 2024 Nov 12.
DOI: 10.1016/j.jocn.2024.110907
Abstrakt: Background and Aim: Recent studies have shown that the CT Perfusion (CTP) parameter of rCBV < 42 % lesion volume can predict 90-day functional outcomes in stroke patients. However, its correlation with discharge outcomes, including functional dependence, has not been investigated. Our study aims to evaluate the relationship between rCBV < 42 % and poor functional outcomes at discharge, defined as a modified Rankin score (mRS) of 3 or higher.
Materials and Methods: This retrospective study analyzed patients with confirmed occlusion on CT angiography, who also received CT perfusion between 9/1/2017 and 10/01/2023. Statistical tests (Student's T, Mann-Whitney U, and Chi-Square) were used to assess differences. Univariable and multivariable logistic regression analyses were performed to evaluate the associations of rCBV < 42 % with discharge mRS. A p-value ≤ 0.05 was considered significant.
Results: A total of 268 patients [median age: 68 years (IQR: 59-77), 56.3 % female] met the inclusion criteria. Among them, 85 patients (31.7 %) received intravenous thrombolysis (IVT), and 221 patients (82.5 %) underwent mechanical thrombectomy (MT). After adjusting for various variables, logistic regression analysis indicated that rCBV < 42 % lesion volume was associated with poor functional outcomes at discharge (aOR = 0.97, p < 0.05). T.
Conclusion: The rCBV < 42 % could be a valuable tool in prognosticating AIS-LVO patients.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Drs. Dhairya Lakhani, Greg Albers, Jeremy Heit, and Vivek Yedavalli are consultants for Rapid (iSchemaView, Menlo Park, CA).
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: