Effectiveness of computed tomography perfusion imaging in stroke management DOI Creative Commons

Martina Cviková,

Michal Haršány, Jan Vinklárek

et al.

Frontiers in Neurology, Journal Year: 2024, Volume and Issue: 15

Published: Aug. 12, 2024

Objectives Current guidelines do not support the use of computed tomography perfusion (CTP) in stroke, except when identifying penumbra during an extended treatment window. Therefore, this study aimed to define yield CTP diagnosing a stroke diagnosis beyond imaging hyperacute phase (0–6 h) and time window (6–24 h). Materials methods All consecutive patients with acute onset symptoms within 24-h underwent imaging. The diagnostic value was calculated against clinical radiological diagnoses stroke. A positive result determined by presence either core or on RAPID summary. Clinical corresponded discharge established if early ischemic changes [Alberta Stroke Program Early CT Score (ASPECTS) <10] were observed baseline scan, infarction confirmed follow-up imaging, symptomatic occlusion evident CTA. Results Between November 2018 2019, 585 neurological deficit multimodal total 500 (85%) included, where 274 (55%) phase, 153 (31%) had 122 (24%) yielded results only (positive predictive specificity 100%). When negative, 43% cases turned out mimics. Patients mimics younger (66 ± 17 vs. 73 13) lower scores National Institutes Health Scale [median 0; interquartile range (IQR) 0–2 median 4; IQR 2–6] compared CTP-negative strokes. Conclusion In our study, consistently indicated brain ischemia; therefore, management, is most beneficial it yields result. should prompt adequate management actions without any delay. Conversely, negative necessitates consideration both non-stroke diagnoses.

Language: Английский

Effectiveness of computed tomography perfusion imaging in stroke management DOI Creative Commons

Martina Cviková,

Michal Haršány, Jan Vinklárek

et al.

Frontiers in Neurology, Journal Year: 2024, Volume and Issue: 15

Published: Aug. 12, 2024

Objectives Current guidelines do not support the use of computed tomography perfusion (CTP) in stroke, except when identifying penumbra during an extended treatment window. Therefore, this study aimed to define yield CTP diagnosing a stroke diagnosis beyond imaging hyperacute phase (0–6 h) and time window (6–24 h). Materials methods All consecutive patients with acute onset symptoms within 24-h underwent imaging. The diagnostic value was calculated against clinical radiological diagnoses stroke. A positive result determined by presence either core or on RAPID summary. Clinical corresponded discharge established if early ischemic changes [Alberta Stroke Program Early CT Score (ASPECTS) <10] were observed baseline scan, infarction confirmed follow-up imaging, symptomatic occlusion evident CTA. Results Between November 2018 2019, 585 neurological deficit multimodal total 500 (85%) included, where 274 (55%) phase, 153 (31%) had 122 (24%) yielded results only (positive predictive specificity 100%). When negative, 43% cases turned out mimics. Patients mimics younger (66 ± 17 vs. 73 13) lower scores National Institutes Health Scale [median 0; interquartile range (IQR) 0–2 median 4; IQR 2–6] compared CTP-negative strokes. Conclusion In our study, consistently indicated brain ischemia; therefore, management, is most beneficial it yields result. should prompt adequate management actions without any delay. Conversely, negative necessitates consideration both non-stroke diagnoses.

Language: Английский

Citations

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