Semiquantitative dynamic computed tomography to predict response to anti-platelet therapy in acute cerebral infarction
| Autor: | T. Mori, T. Mokudai, K. Shimizu, M. Fukumoto, K. Mori, K. Chokyu |
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| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Neurology Hemodynamics Central nervous system disease Modified Rankin Scale Predictive Value of Tests medicine Humans Radiology Nuclear Medicine and imaging Enzyme Inhibitors Neuroradiology Aged medicine.diagnostic_test business.industry Vascular disease Cerebral infarction Brain Infarction Middle Cerebral Artery medicine.disease Prognosis Cerebral Angiography Treatment Outcome Acute Disease Methacrylates Female Neurology (clinical) Radiology Thromboxane-A Synthase Cardiology and Cardiovascular Medicine business Nuclear medicine Tomography X-Ray Computed Platelet Aggregation Inhibitors Cerebral angiography |
| Zdroj: | Neuroradiology. 44(4) |
| ISSN: | 0028-3940 |
| Popis: | We investigated whether dynamic computed tomography (CT) in patients with acute cerebral infarction could identify patients likely to respond to anti-platelet therapy. Seventy patients underwent semiquantitative dynamic CT within 6 h as well as cerebral angiography. All then received anti-platelet therapy with a thromboxane A2 synthetase inhibitor. Peak value (pv) and time-to-peak (tp) (time-density curves) for the Sylvian fissure were extracted from dynamic CT data and standardizing interpatient data, two indices, PV/TP index and TP index, were prepared following a standard semiquantitative manner. Both PV/TP index and TP index were effective in discriminating between 48 responders (modified Rankin scale (mRS): 0 to 2) and 22 non-responders (mRS: 3 to 5, or death: 6; both P0.0001). High PV/TP index (or=0.8) was a strong indicator of favorable response. Most of these patients maintained regional cerebral blood flow (rCBF) via anterograde flow or collaterals, with a TP indexor=1.1. Low PV/TP index (or=0.4) predicted non-response associated with increased TP index (1.1) and non-compensated rCBF. Intermediate PV/TP values could not predict outcome. Dynamic CT prior to therapy can identify patients with acute cerebral infarction who are treatable with anti-platelet therapy alone. |
| Databáze: | OpenAIRE |
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