CT-Based Assessment of Acute Stroke: CT, CT Angiography, and Xenon-Enhanced CT Cerebral Blood Flow
| Autor: | Charles A. Jungreis, Megan M. Kilpatrick, Melanie B. Fukui, Lawrence R. Wechsler, Amin B. Kassam, Steven Goldstein, James Gebel, Howard Yonas |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Brain Infarction Male medicine.medical_specialty Xenon Adolescent Ischemia Hemodynamics Infarction symbols.namesake Humans Medicine Thrombolytic Therapy cardiovascular diseases Stroke Fisher's exact test Aged Advanced and Specialized Nursing medicine.diagnostic_test business.industry Vascular disease Middle Aged medicine.disease Cerebral Angiography Cerebral blood flow Cerebrovascular Circulation Acute Disease Angiography symbols Female Neurology (clinical) Radiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Stroke. 32:2543-2549 |
| ISSN: | 1524-4628 0039-2499 |
| Popis: | Only a small percentage of acute-stroke patients receive thrombolytic therapy because of time constraints and the risks associated with thrombolytic therapy. We sought to determine whether xenon-enhanced CT (XeCT) cerebral blood flow (CBF) and/or CT angiography (CTA) in conjunction with CT can distinguish subgroups of acute ischemic stroke victims and thereby better predict the subgroups most likely to benefit and not to benefit from thrombolytic therapy.An analysis of 51 patients who had a CT, CTA, and stable XeCT CBF examination within 24 hours of stroke symptom onset was conducted. These initial radiographic studies and National Institutes of Health Stroke Scale score on admission were assessed to determine whether they could predict new infarction on follow-up CT or discharge disposition by use of the Fisher exact test to determine statistical significance.Patients with no infarction on initial CT and normal XeCT CBF had significantly fewer new infarctions and were discharged home more often than those with compromised CBF. The same held true for patients with an open internal carotid artery and middle cerebral artery by CTA and normal CT compared with those with an occluded internal carotid artery and/or middle cerebral artery by CTA. Either was superior to CT and the National Institutes of Health Stroke Scale in prediction of outcome. Both enable the selection of a group of patients not identifiable by CT alone that would do well without being exposed to the risks of thrombolytic therapy. This study included too few patients to statistically assess the role of combining CTA and XeCT CBF information.The combination of CT, CTA, and Xe/CT CBF does define potentially significant subgroups of patients. The utility of this classification is supported by the observation that CTA and XeCT CBF are superior to CT alone in predicting infarction on follow-up CT and clinical outcome. This information may be useful in selecting patients for acute-stroke treatment. |
| Databáze: | OpenAIRE |
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