Novel quantitative approach for crossed cerebellar diaschisis detection in acute ischemic stroke using CT perfusion
| Autor: | Maja Ukmar, Paola Caruso, Carlo Lugnan, Giovanni Furlanis, Ilario Scali, Marcello Naccarato, Paolo Manganotti, Alex Buoite Stella, Lara Stragapede, Miloš Ajčević |
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| Přispěvatelé: | Naccarato, M., Ajcevic, M., Furlanis, G., Lugnan, C., Buoite Stella, A., Scali, I., Caruso, P., Stragapede, L., Ukmar, M., Manganotti, P. |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Cerebellum Stroke severity Acute ischemic stroke Crossed cerebellar diaschisi Perfusion scanning Brain Ischemia 03 medical and health sciences 0302 clinical medicine Image processing Modified Rankin Scale Internal medicine Humans Medicine Functional neuroimaging 030212 general & internal medicine Asymmetry Index Ischemic Stroke business.industry Crossed cerebellar diaschisis CT perfusion Perfusion Stroke medicine.anatomical_structure Neurology Cerebrovascular Circulation Cardiology Neurology (clinical) Tomography X-Ray Computed business 030217 neurology & neurosurgery |
| Popis: | Purpose Crossed cerebellar diaschisis (CCD) is a common finding in hyper-acute ischemic stroke, related to supratentorial dysfunction of the contralateral hemisphere. Several studies investigated a possible relationship between CCD and clinical outcomes but still no evidence emerged. We proposed a novel quantitative whole cerebellum analysis using CT perfusion (CTP) imaging to investigate the relationship between CCD and stroke severity, hypoperfused volume and outcome measures. Methods 55 patients with supratentorial ischemic stroke who underwent CTP evaluation within 4.5 h since symptom onset were enrolled. CCD was evaluated by CTP image-processing and by calculating the mean transit time (MTT)-map asymmetry index in the whole cerebellum. MTT asymmetry correlation with ischemic volume and clinical outcomes was investigated. Results MTT asymmetry was found in most of the included patients and significantly correlated with NIH Stroke Scale (NIHSS) score at baseline and CTP ischemic volume. MTT asymmetry was significantly correlated with hemorrhagic transformation, NIHSS and modified Rankin Scale (mRS) score on discharge in treated patients. Conclusions CCD was detectable by CTP in acute supratentorial ischemic stroke by processing the whole cerebellum volume. CCD perfusion asymmetry was significantly correlated with neurological and perfusion deficit on admission as well as with clinical outcomes in treated patients. |
| Databáze: | OpenAIRE |
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