Document Detail


Semiquantitative dynamic computed tomography to predict response to anti-platelet therapy in acute cerebral infarction.
MedLine Citation:
PMID:  11914802     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 P<0.0001). 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 index <or=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.
Authors:
K Chokyu; M Fukumoto; T Mori; T Mokudai; K Mori; K Shimizu
Publication Detail:
Type:  Journal Article     Date:  2002-02-02
Journal Detail:
Title:  Neuroradiology     Volume:  44     ISSN:  0028-3940     ISO Abbreviation:  Neuroradiology     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-03-26     Completed Date:  2002-06-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1302751     Medline TA:  Neuroradiology     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  286-93     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Kochi Medical School, Kohasu, Okou, Nankoku, Kochi 783-8505, Japan. choukyuu-nsu@umin.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Brain / radiography
Cerebral Angiography
Enzyme Inhibitors / therapeutic use*
Female
Humans
Infarction, Middle Cerebral Artery / drug therapy,  radiography*
Male
Methacrylates / therapeutic use*
Platelet Aggregation Inhibitors / therapeutic use*
Predictive Value of Tests
Prognosis
Thromboxane-A Synthase / antagonists & inhibitors*
Tomography, X-Ray Computed*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Enzyme Inhibitors; 0/Methacrylates; 0/Platelet Aggregation Inhibitors; 82571-53-7/ozagrel; EC 5.3.99.5/Thromboxane-A Synthase
Comments/Corrections
Comment In:
Neuroradiology. 2002 Aug;44(8):715; author reply 716-7   [PMID:  12420709 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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