| Assessing Prognosis of Areas of Acute Cerebral Ischemia Using Perfusion CT. | |
| | |
MedLine Citation:
|
PMID: 20587253 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
Summary: Vascular recanalization by the vascular reconstruction method can dramatically improve ischemic symptoms in patients with acute cerebral ischemia. However, this treatment method is frequently associated with haemorrhagic complications. The indications for this therapeutic approach have been described in a number of studies in the literature. The present paper discusses the possibility of assessing the prognosis of ischemic areas using perfusion CT (PCT) by comparing the results obtained before and after thrombolytic therapy. Twenty-six patients underwent vascular reconstruction at our hospital between July 2002 and March 2004. Of these patients, six who underwent PCT before treatment and showed adequate recanalization following vascular reconstruction were included in the present study. PCT images were obtained using the first-pass bolus-tracking method with a 16-row multislice helical CT scanner. Areas of cerebral ischemia were evaluated by CT before and after vascular reconstruction. A region of interest was placed in the area showing low density in CT images before vascular reconstruction. The mean average CBF (mL/min/100 g), CBV (mL/100 g), and MTT (s) values were calculated in areas with and without cerebral infarction after vascular reconstruction. The %CBF, % CBV, and %MTT values relative to the normal side were evaluated with reference to the time until recanalization. Transarterial vascular reconstruction resulted in full recanalization in four patients and partial recanalization in two. The mean time from onset to recanalization was 284.7 +/- 63.27 minutes and was not longer than six hours in any patient. The patient prognosis results in terms of GOS were GR in two patients, MD in three patients, and SD in one patient. Based on comparison of the time after examination to recanalization, the %CBF showed a significant positive correlation in the salvaged area (Y = 47.321 + 2.491 x %CBF:R(2) = 0.792, p < 0.05). A significant correlation was not observed in %CBV, but %MTT showed a significant negative correlation (Y = 269.45 - 0.356 x %MTT:R(2) = 0.794, p < 0.05). The %CBF and %MTT results obtained by PCT performed before transarterial vascular reconstruction suggest that it may be possible to estimate the time before vascular reconstruction and the relationship with prognosis. These findings are expected to help ensure the appropriate application of vascular reconstruction and to provide useful information for developing optimal therapeutic protocols, thus reducing complications. In addition, because the results are based on the time after examination, the appropriate therapeutic approach can be determined even when the time of onset of ischemia is uncertain. |
| | |
Authors:
|
M Hayakawa; M Negoro; H Toyama; K Irie; S Imizu; K Iritani; J Hayashi; Y Idesawa; K Katada; T Kanno |
Related Documents
:
|
10511343 - Parasagittal cerebral injury: magnetic resonance findings. 10719653 - Magnetic resonance imaging of cerebral microbleeds. 8494443 - Intracardiac ectopic thyroid: conservative surgical treatment. |
Publication Detail:
|
Type: Journal Article Date: 2008-05-15 |
Journal Detail:
|
Title: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Volume: 10 Suppl 2 ISSN: 1591-0199 ISO Abbreviation: Interv Neuroradiol Publication Date: 2004 Dec |
Date Detail:
|
Created Date: 2010-06-30 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9602695 Medline TA: Interv Neuroradiol Country: Italy |
Other Details:
|
Languages: eng Pagination: 69-78 Citation Subset: - |
Affiliation:
|
Department of Neurosurgery, School of Medicine, Fujita Health University; Toyoake, Aichi, Japan - hayakawa@fujita-hu.ac.jp. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Efficacy and limitations of the neuroform stent system for intracranial aneurysms.
Next Document: Simulation Study of Distal Balloon Protection Systems during Carotid Artery Stenting.