| The vascular mean transit time: a surrogate for the penumbra flow threshold? | |
| | |
MedLine Citation:
|
PMID: 21045862 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Depicting the salvageable tissue is increasingly used in the clinical setting following stroke. As absolute cerebral blood flow (CBF) is difficult to measure using perfusion magnetic resonance or computed tomography and has limitations as a penumbral marker, time-based variables, particularly the mean transit time (MTT), are routinely used as surrogates. However, a direct validation of MTT as a predictor of the penumbra threshold using gold-standard positron emission tomography (PET) is lacking. Using (15)O-PET data sets obtained from two independent acute stroke samples (N=7 and N=30, respectively), we derived areas under the curve (AUCs), optimal thresholds (OTs), and 90%-specificity thresholds (90%-Ts) from receiver operating characteristic curves for absolute MTT, MTT delay, and MTT ratio to predict three penumbra thresholds ('classic': CBF <20 mL/100 g per min; 'normalized': CBF ratio <0.5; and 'stringent': both CBF <20 mL/100 g per min and oxygen extraction fraction >0.55). In sample 1, AUCs ranged from 0.79 to 0.92, indicating good validity; OTs ranged from 7.8 to 8.3 seconds, 2.8 to 4.7 seconds, and 151% to 267% for absolute MTT, MTT delay, and MTT ratio, respectively, while as expected, 90%-Ts were longer. There was no significant difference between sample 1 and sample 2 for any of the above measurements, save for a single MTT parameter with a single penumbra threshold. These consistent findings from gold-standard PET obtained in two independent cohorts document that MTT is a very good surrogate to CBF for depicting the penumbra threshold. |
| | |
Authors:
|
Emmanuel Carrera; P Simon Jones; Serge Iglesias; Joseph V Guadagno; Elizabeth A Warburton; Tim D Fryer; Franklin I Aigbirhio; Jean-Claude Baron |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-11-03 |
Journal Detail:
|
Title: Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Volume: 31 ISSN: 1559-7016 ISO Abbreviation: J. Cereb. Blood Flow Metab. Publication Date: 2011 Apr |
Date Detail:
|
Created Date: 2011-04-01 Completed Date: 2011-05-27 Revised Date: 2012-04-02 |
Medline Journal Info:
|
Nlm Unique ID: 8112566 Medline TA: J Cereb Blood Flow Metab Country: United States |
Other Details:
|
Languages: eng Pagination: 1027-35 Citation Subset: IM |
Affiliation:
|
Department of Clinical Neurosciences, The Stroke Research Group, University of Cambridge, Cambridge, UK. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Aged, 80 and over Blood Circulation Time Cerebral Infarction / physiopathology, radionuclide imaging Cerebrovascular Circulation / physiology* Cohort Studies Data Interpretation, Statistical Female Humans Male Middle Aged Positron-Emission Tomography ROC Curve Reperfusion Risk Factors Stroke / physiopathology*, radionuclide imaging Young Adult |
| Grant Support | |
ID/Acronym/Agency:
|
G0001219//Medical Research Council; G0500874//Medical Research Council |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Functions of Nogo proteins and their receptors in the nervous system.
Next Document: Experimental stroke-induced changes in the bone marrow reveal complex regulation of leukocyte respon...