Flat Panel CT Scanning Is Helpful in Predicting Hemorrhagic Transformation in Acute Ischemic Stroke Patients Undergoing Endovascular Thrombectomy
| Autor: | Jiping Sun, Rui Shen, Feng Wang, Yi Xu, Liuwei Chen, Quanbin Zhang, Xiang Zhang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Article Subject Flat panel General Biochemistry Genetics and Molecular Biology 030218 nuclear medicine & medical imaging Lesion 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Hounsfield scale medicine Humans Acute ischemic stroke Aged Cerebral Hemorrhage Ischemic Stroke Retrospective Studies Thrombectomy General Immunology and Microbiology business.industry Endovascular Procedures Area under the curve Brain Retrospective cohort study General Medicine Middle Aged Extravasation Predictive value of tests Medicine Female Radiology medicine.symptom business Tomography X-Ray Computed 030217 neurology & neurosurgery Research Article |
| Zdroj: | BioMed Research International, Vol 2021 (2021) BioMed Research International |
| ISSN: | 2314-6141 2314-6133 |
| Popis: | Purpose. Hyperdense lesions are frequently revealed on flat panel CT (FP-CT) immediately after endovascular thrombectomy in patients with acute ischemic stroke. This study is aimed at discriminating hyperdense lesions caused by extravasation plus hemorrhage from those caused by contrast extravasation alone. Methods. We retrospectively analyzed clinical and radiological data of patients who underwent an immediate postprocedure FP-CT scan and a follow-up noncontrast CT 24 hours after thrombectomy. We especially focused on the Maximum Hounsfield Units (HUmax) of each hyperdense lesion. A hyperdense lesion was judged to be hemorrhagic when it persisted on noncontrast CT and/or developed a mass effect. Results. Of 81 patients included in this study, 32 (39.5%) patients presented 41 hyperdense lesions on FP-CT. The chance of hemorrhagic transformation is higher in patients with hyperdense lesions on FP-CT than that in patients without hyperdense lesions (23/32 vs. 1/49, p < 0.001 ). The HUmax of hyperdensity on FP-CT can predict hemorrhagic transformation with an area under the curve of 0.805 (95% CI: 0.67-0.94, p = 0.02 ). The sensitivity, specificity, positive, and negative predictive values of hyperdensity on FP-CT for hemorrhagic transformation were 96%, 84%, 72%, and 98%, respectively. A HUmax of >600 predicted hemorrhagic transformation with a sensitivity of 50% and a specificity of 100%. Conclusions. The presence of hyperdensity on FP-CT can predict hemorrhagic transformation with a high sensitivity and negative predictive value. The measurement of HUmax of hyperdense lesion on FP-CT can be applied to the management of patients undergoing endovascular recanalization. |
| Databáze: | OpenAIRE |
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