PortalPublikationenCT Hypoperfusion-Hypodensity Mismatch to Identify Patients W...

CT Hypoperfusion-Hypodensity Mismatch to Identify Patients With Acute Ischemic Stroke Within 4.5 Hours of Symptom Onset

Standard

CT Hypoperfusion-Hypodensity Mismatch to Identify Patients With Acute Ischemic Stroke Within 4.5 Hours of Symptom Onset. / Sporns, Peter B; Kemmling, André; Minnerup, Heike; Meyer, Lennart; Krogias, Christos; Puetz, Volker; Thierfelder, Kolja; Duering, Marco; Kaiser, Daniel; Langner, Soenke; Massoth, Christina; Brehm, Alex; Rotkopf, Lukas; Kunz, Wolfgang G; Karch, André; Fiehler, Jens; Heindel, Walter; Schramm, Peter; Royl, Georg; Wiendl, Heinz; Psychogios, Marios; Minnerup, Jens.

in: NEUROLOGY, Jahrgang 97, Nr. 21, 23.11.2021, S. e2088-e2095.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Sporns, PB, Kemmling, A, Minnerup, H, Meyer, L, Krogias, C, Puetz, V, Thierfelder, K, Duering, M, Kaiser, D, Langner, S, Massoth, C, Brehm, A, Rotkopf, L, Kunz, WG, Karch, A, Fiehler, J, Heindel, W, Schramm, P, Royl, G, Wiendl, H, Psychogios, M & Minnerup, J 2021, 'CT Hypoperfusion-Hypodensity Mismatch to Identify Patients With Acute Ischemic Stroke Within 4.5 Hours of Symptom Onset', NEUROLOGY, Jg. 97, Nr. 21, S. e2088-e2095. https://doi.org/10.1212/WNL.0000000000012891

APA

Sporns, P. B., Kemmling, A., Minnerup, H., Meyer, L., Krogias, C., Puetz, V., Thierfelder, K., Duering, M., Kaiser, D., Langner, S., Massoth, C., Brehm, A., Rotkopf, L., Kunz, W. G., Karch, A., Fiehler, J., Heindel, W., Schramm, P., Royl, G., ... Minnerup, J. (2021). CT Hypoperfusion-Hypodensity Mismatch to Identify Patients With Acute Ischemic Stroke Within 4.5 Hours of Symptom Onset. NEUROLOGY, 97(21), e2088-e2095. https://doi.org/10.1212/WNL.0000000000012891

Vancouver

Sporns PB, Kemmling A, Minnerup H, Meyer L, Krogias C, Puetz V et al. CT Hypoperfusion-Hypodensity Mismatch to Identify Patients With Acute Ischemic Stroke Within 4.5 Hours of Symptom Onset. NEUROLOGY. 2021 Nov 23;97(21):e2088-e2095. https://doi.org/10.1212/WNL.0000000000012891

Bibtex

@article{1fb5f1fd8d7f4135b06d881c8bd0efff,
title = "CT Hypoperfusion-Hypodensity Mismatch to Identify Patients With Acute Ischemic Stroke Within 4.5 Hours of Symptom Onset",
abstract = "BACKGROUND AND OBJECTIVES: To test the hypothesis that CT hypoperfusion-hypodensity mismatch identifies patients with ischemic stroke within 4.5 hours of symptom onset.METHODS: We therefore performed the Retrospective Multicenter Hypoperfusion-Hypodensity Mismatch for The identification of Patients With Stroke Within 4.5 Hours study of patients with acute ischemic stroke and known time of symptom onset. The predictive values of hypoperfusion-hypodensity mismatch for the identification of patients with symptom onset within 4.5 hours were the main outcome measure.RESULTS: Of 666 patients, 548 (82.3%) had multimodal CT within 4.5 hours and 118 (17.7%) beyond 4.5 hours. Hypoperfusion-hypodensity mismatch was visible in 516 (94.2%) patients with symptom onset within and in 30 (25.4%) patients beyond 4.5 hours. CT hypoperfusion-hypodensity mismatch identified patients within 4.5 hours of stroke onset with 94.2% (95% confidence interval [CI] 91.9%-95.8%) sensitivity, 74.6% (95% CI 66.0%-81.6%) specificity, 94.5% (95% CI 92.3%-96.1%) positive predictive value, and 73.3% (95% CI 64.8%-80.4%) negative predictive value. Interobserver agreement for hypoperfusion-hypodensity mismatch was substantial (κ = 0.61, 95% CI 0.53-0.69).DISCUSSION: Patients with acute ischemic stroke with absence of a hypodensity on native CT (NCCT) within the hypoperfused core lesion on perfusion CT (hypoperfusion-hypodensity mismatch) are likely to be within the time window of thrombolysis. Applying this method may guide the decision to use thrombolysis in patients with unknown time of stroke onset.TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov Identifier: NCT04277728.CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that CT hypoperfusion-hypodensity mismatch identifies patients with stroke within 4.5 hours of onset.",
author = "Sporns, {Peter B} and Andr{\'e} Kemmling and Heike Minnerup and Lennart Meyer and Christos Krogias and Volker Puetz and Kolja Thierfelder and Marco Duering and Daniel Kaiser and Soenke Langner and Christina Massoth and Alex Brehm and Lukas Rotkopf and Kunz, {Wolfgang G} and Andr{\'e} Karch and Jens Fiehler and Walter Heindel and Peter Schramm and Georg Royl and Heinz Wiendl and Marios Psychogios and Jens Minnerup",
note = "{\textcopyright} 2021 American Academy of Neurology.",
year = "2021",
month = nov,
day = "23",
doi = "10.1212/WNL.0000000000012891",
language = "English",
volume = "97",
pages = "e2088--e2095",
journal = "NEUROLOGY",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "21",

}

RIS

TY - JOUR

T1 - CT Hypoperfusion-Hypodensity Mismatch to Identify Patients With Acute Ischemic Stroke Within 4.5 Hours of Symptom Onset

AU - Sporns, Peter B

AU - Kemmling, André

AU - Minnerup, Heike

AU - Meyer, Lennart

AU - Krogias, Christos

AU - Puetz, Volker

AU - Thierfelder, Kolja

AU - Duering, Marco

AU - Kaiser, Daniel

AU - Langner, Soenke

AU - Massoth, Christina

AU - Brehm, Alex

AU - Rotkopf, Lukas

AU - Kunz, Wolfgang G

AU - Karch, André

AU - Fiehler, Jens

AU - Heindel, Walter

AU - Schramm, Peter

AU - Royl, Georg

AU - Wiendl, Heinz

AU - Psychogios, Marios

AU - Minnerup, Jens

N1 - © 2021 American Academy of Neurology.

PY - 2021/11/23

Y1 - 2021/11/23

N2 - BACKGROUND AND OBJECTIVES: To test the hypothesis that CT hypoperfusion-hypodensity mismatch identifies patients with ischemic stroke within 4.5 hours of symptom onset.METHODS: We therefore performed the Retrospective Multicenter Hypoperfusion-Hypodensity Mismatch for The identification of Patients With Stroke Within 4.5 Hours study of patients with acute ischemic stroke and known time of symptom onset. The predictive values of hypoperfusion-hypodensity mismatch for the identification of patients with symptom onset within 4.5 hours were the main outcome measure.RESULTS: Of 666 patients, 548 (82.3%) had multimodal CT within 4.5 hours and 118 (17.7%) beyond 4.5 hours. Hypoperfusion-hypodensity mismatch was visible in 516 (94.2%) patients with symptom onset within and in 30 (25.4%) patients beyond 4.5 hours. CT hypoperfusion-hypodensity mismatch identified patients within 4.5 hours of stroke onset with 94.2% (95% confidence interval [CI] 91.9%-95.8%) sensitivity, 74.6% (95% CI 66.0%-81.6%) specificity, 94.5% (95% CI 92.3%-96.1%) positive predictive value, and 73.3% (95% CI 64.8%-80.4%) negative predictive value. Interobserver agreement for hypoperfusion-hypodensity mismatch was substantial (κ = 0.61, 95% CI 0.53-0.69).DISCUSSION: Patients with acute ischemic stroke with absence of a hypodensity on native CT (NCCT) within the hypoperfused core lesion on perfusion CT (hypoperfusion-hypodensity mismatch) are likely to be within the time window of thrombolysis. Applying this method may guide the decision to use thrombolysis in patients with unknown time of stroke onset.TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov Identifier: NCT04277728.CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that CT hypoperfusion-hypodensity mismatch identifies patients with stroke within 4.5 hours of onset.

AB - BACKGROUND AND OBJECTIVES: To test the hypothesis that CT hypoperfusion-hypodensity mismatch identifies patients with ischemic stroke within 4.5 hours of symptom onset.METHODS: We therefore performed the Retrospective Multicenter Hypoperfusion-Hypodensity Mismatch for The identification of Patients With Stroke Within 4.5 Hours study of patients with acute ischemic stroke and known time of symptom onset. The predictive values of hypoperfusion-hypodensity mismatch for the identification of patients with symptom onset within 4.5 hours were the main outcome measure.RESULTS: Of 666 patients, 548 (82.3%) had multimodal CT within 4.5 hours and 118 (17.7%) beyond 4.5 hours. Hypoperfusion-hypodensity mismatch was visible in 516 (94.2%) patients with symptom onset within and in 30 (25.4%) patients beyond 4.5 hours. CT hypoperfusion-hypodensity mismatch identified patients within 4.5 hours of stroke onset with 94.2% (95% confidence interval [CI] 91.9%-95.8%) sensitivity, 74.6% (95% CI 66.0%-81.6%) specificity, 94.5% (95% CI 92.3%-96.1%) positive predictive value, and 73.3% (95% CI 64.8%-80.4%) negative predictive value. Interobserver agreement for hypoperfusion-hypodensity mismatch was substantial (κ = 0.61, 95% CI 0.53-0.69).DISCUSSION: Patients with acute ischemic stroke with absence of a hypodensity on native CT (NCCT) within the hypoperfused core lesion on perfusion CT (hypoperfusion-hypodensity mismatch) are likely to be within the time window of thrombolysis. Applying this method may guide the decision to use thrombolysis in patients with unknown time of stroke onset.TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov Identifier: NCT04277728.CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that CT hypoperfusion-hypodensity mismatch identifies patients with stroke within 4.5 hours of onset.

U2 - 10.1212/WNL.0000000000012891

DO - 10.1212/WNL.0000000000012891

M3 - SCORING: Journal article

C2 - 34649883

VL - 97

SP - e2088-e2095

JO - NEUROLOGY

JF - NEUROLOGY

SN - 0028-3878

IS - 21

ER -