Document Detail

Functional image of dynamic computed tomography in diagnostic and prognostic evaluation of ischemic stroke within the first 6 hours.
MedLine Citation:
PMID:  8248976     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: It is important to make a diagnosis before a low-density area appears on computed tomography for appropriate management of acute ischemic stroke. We report the diagnostic and prognostic usefulness of functional image of dynamic computed tomography for acute ischemic stroke. METHODS: Forty-seven patients with ischemic strokes within 6 hours of ictus underwent dynamic computed tomography in which functional images were obtained. These findings were compared with angiographic findings, follow-up computed tomography, and clinical outcome. RESULTS: The functional images were categorized into three groups: (1) cortical type: abnormalities on time to peak image and/or corrected mean transit time image involving mainly cortical structures (29 cases); (2) noncortical type: abnormalities on either or both images limited to noncortical structures (7 cases); and (3) normal type: no abnormalities on both images (11 cases). Cortical type as a diagnostic test for arterial trunk occlusion had a good sensitivity (100%), specificity (95%), and accuracy (98%). Infarction volume on follow-up computed tomography correlated with extension of prolonged time-to-peak area (r = .80, P < .01) and that of prolonged corrected mean transit time area (r = .81, P < .01). Cortical type was associated with significantly unfavorable outcome (P < .01). CONCLUSIONS: Functional image of dynamic computed tomography findings predicted arterial trunk occlusion, infarction volume, and clinical outcome. Therefore, this technique would be useful not only for indicating definitive angiography and subsequent therapy but for evaluating the effectiveness of surgical or medical recanalization.
T Toriyama; Y Tanizaki; K Hongo; M Osawa; S Kobayashi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  24     ISSN:  0039-2499     ISO Abbreviation:  Stroke     Publication Date:  1993 Dec 
Date Detail:
Created Date:  1994-01-04     Completed Date:  1994-01-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1933-44     Citation Subset:  IM    
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
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MeSH Terms
Acute Disease
Brain Ischemia / diagnosis*
Cerebral Angiography
Cerebral Cortex / blood supply
Middle Aged
Outcome Assessment (Health Care)
Regional Blood Flow
Retrospective Studies
Risk Factors
Time Factors
Tomography, X-Ray Computed / methods*

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