Department of Neurosurgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong 266035, China , wzhigang202212@163.com
Abstract: (612 Views)
Background:To clarify the value of computed tomography (CT) perfusion (CTP) imaging in diagnosing early cerebral infarction (CI). Materials and Methods:Totally 100 suspected early CI patients in our hospital from May 2019 to May 2022 were selected and divided into observation and control groups based on examination methods, with 50 patients per group. In control group, patients received plain scanning through 64 row multi-slice spiral CT. On this basis, patients in observation group received CTP in certain area. Comparison of detection rate between groups was conducted. The observation indicators of CI patients detected by CTP in observation group were recorded and analyzed, including the mean transit time (MTT) of the same blood volume, cerebral blood flow (CBF), cerebral blood volume (CBV), and time to peak (TTP). The satisfaction with examination in both groups was explored. Results: CTP presented higher detection accuracy than plain CT scanning (P < 0.05). TTP presented elevation and MTT, CBV and CBF presented depletion in CI position than those in other cerebral position (P < 0.05). TTP, MTT, CBV and CBF presented statistical significance between ischemic penumbra (IP) position and CI position (P < 0.05). The satisfaction degree was elevated in observation group relative to control group (P < 0.05). Conclusion: CTP in early CI has higher diagnostic value and accuracy and elevates patient satisfaction, helping reduce disability and mortality. Additionally, CTP has high maneuverability and flexibility, and can measure IP, reducing the degree of brain tissue damage in patients, and is worthy of clinical application.
1. 1. Schrader I, Wilk D, Jansen O, et al. (2013) Whole-brain perfusion CT using a toggling table-technique to predict final infarct volume in acute ischemic stroke. RoFo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, 185(10): 975-82. [DOI:10.1055/s-0033-1335566]
2. Tan XL, Xue YQ, Ma T, et al. (2015) Partial eNOS deficiency causes spontaneous thrombotic cerebral infarction, amyloid angiopathy and cognitive impairment. Molecular Neurodegeneration, 10: 24. [DOI:10.1186/s13024-015-0020-0]
3. Zeng Q, Lin K, Yao M, et al. (2015) Significant correlation between cystatin C, cerebral infarction, and potential biomarker for increased risk of stroke. Current neurovascular research, 12(1): 40-6. [DOI:10.2174/1567202612666150102150941]
4. Abbasian S, Kargar Moghaddam M, Nazari B (2022) The effect of high-intensity treadmill training on motor function in patients with a stroke. SJMSHM, 4 (1): 1-3. [DOI:10.47176/sjmshm.4.1.1]
5. Ke J and Jing M (2016) Analysis of treatment effect of urinary kallidinogenase combined with edaravone on massive cerebral infarction. Biomedical Reports, 5(2): 155-8. [DOI:10.3892/br.2016.692]
7. Béjot Y, Duloquin G, Thomas Q, et al. (2021) Temporal Trends in the Incidence of Ischemic Stroke in Young Adults: Dijon Stroke Registry. Neuroepidemiology, 55(3): 239-44. [DOI:10.1159/000516054]
8. Paul S and Candelario-Jalil E (2021) Emerging neuroprotective strategies for the treatment of ischemic stroke: An overview of clinical and preclinical studies. Experimental Neurology, 335: 113518. [DOI:10.1016/j.expneurol.2020.113518]
9. Herpich F and Rincon F (2020) Management of acute ischemic stroke. Critical Care Medicine, 48(11): 1654-63. [DOI:10.1097/CCM.0000000000004597]
10. Ospel JM, Holodinsky JK, Goyal M (2020) Management of acute ischemic stroke due to large-vessel occlusion: JACC Focus Seminar. Journal of the American College of Cardiology, 75(15): 1832-43. [DOI:10.1016/j.jacc.2019.10.034]
11. Joundi RA and Menon BK (2021) Thrombus composition, imaging, and outcome prediction in acute ischemic stroke. Neurology, 97(20-2): S68-s78. [DOI:10.1212/WNL.0000000000012796]
12. Schrader I, Wilk D, Jansen O, et al. (2013) Whole-brain perfusion CT using a toggling table technique to predict final infarct volume in acute ischemic stroke. RoFo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, 184(10): 975-82. [DOI:10.1055/s-0033-1335566]
13. Václavík D, Volný O, Cimflová P, et al. (2022) The importance of CT perfusion for diagnosis and treatment of ischemic stroke in anterior circulation. Journal of Integrative Neuroscience, 21(3): 92. [DOI:10.31083/j.jin2103092]
14. Campbell BCV, Majoie C, Albers GW, et al. (2019) Penumbral imaging and functional outcome in patients with anterior circulation ischaemic stroke treated with endovascular thrombectomy versus medical therapy: a meta-analysis of individual patient-level data. The Lancet Neurology, 18(1): 46-55. [DOI:10.1016/S1474-4422(18)30314-4]
15. Hurford R, Sekhar A, Hughes TAT, et al. (2020) Diagnosis and management of acute ischaemic stroke. Practical Neurology, 20(4): 304-16. [DOI:10.1136/practneurol-2020-002557]
16. Malinova V, Dolatowski K, Schramm P, et al. (2016) Early whole-brain CT perfusion for detection of patients at risk for delayed cerebral ischemia after subarachnoid hemorrhage. Journal of Neurosurgery, 125(1): 128-36. [DOI:10.3171/2015.6.JNS15720]
17. Martha SR, Fraser JF, Pennypacker KR (2019) Acid-Base and Electrolyte Changes Drive Early Pathology in Ischemic Stroke. Neuromolecular Medicine, 21(4): 540-5. [DOI:10.1007/s12017-019-08555-5]
18. Bektas H, Wu TC, Kasam M, et al. (2010) Increased blood-brain barrier permeability on perfusion CT might predict malignant middle cerebral artery infarction. Stroke, 41(11): 2539-44. [DOI:10.1161/STROKEAHA.110.591362]
19. Shen J, Li X, Li Y, et al. (2017) Comparative accuracy of CT perfusion in diagnosing acute ischemic stroke: A systematic review of 27 trials. PloS one, 12(5): e0176622. [DOI:10.1371/journal.pone.0176622]
20. Lin K, Do KG, Ong P, et al. (2009) Perfusion CT improves diagnostic accuracy for hyperacute ischemic stroke in the 3-hour window: study of 100 patients with diffusion MRI confirmation. (Basel, Switzerland) Cerebrovascular Diseases, 28(1): 72-9. [DOI:10.1159/000219300]
21. Chu Y, Ma G, Xu XQ, et al. (2022) Total and regional ASPECT score for non-contrast CT, CT angiography, and CT perfusion: inter-rater agreement and its association with the final infarction in acute ischemic stroke patients. (Stockholm, Sweden: 1987) Acta Radiological, 63(8): 1093-101. [DOI:10.1177/02841851211029080]
22. Saini M and Butcher K (2009) Advanced imaging in acute stroke management-Part I: Computed tomographic. Neurology India, 57(5): 541-9. [DOI:10.4103/0028-3886.57791]
23. Butcher K and Emery D (2010) Acute stroke imaging. Part II: The ischemic penumbra. The Canadian Journal of Neurological Sciences, 37(1): 17-27. [DOI:10.1017/S0317167100009604]
24. van der Hoeven EJ, Dankbaar JW, Algra A, et al. (2015) Additional diagnostic value of computed tomography perfusion for detection of acute ischemic stroke in the posterior circulation. Stroke, 46(4): 1113-5. [DOI:10.1161/STROKEAHA.115.008718]
25. Das T, Settecase F, Boulos M, et al. (2015) Multimodal CT provides improved performance for lacunar infarct detection. AJNR American Journal of Neuroradiology, 36(6): 1069-75. [DOI:10.3174/ajnr.A4255]
26. Rudilosso S, Urra X, San Román L, et al. (2015) Perfusion Deficits and Mismatch in Patients with Acute Lacunar Infarcts Studied with Whole-Brain CT Perfusion. AJNR American journal of neuroradiology, 36(8): 1407-12. [DOI:10.3174/ajnr.A4303]
Sun B, Wang Z. The application value of computed tomography perfusion imaging in diagnosing early cerebral infarction. Int J Radiat Res 2024; 22 (1) :139-143 URL: http://ijrr.com/article-1-5225-en.html