Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment

Friederike Austein; Antonia Carlotta Fischer; Jens Fiehler; Olav Jansen; Thomas Lindner; Susanne Gellißen

doi:10.1155/2021/9933015

Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment

Standard

Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment. / Austein, Friederike; Fischer, Antonia Carlotta; Fiehler, Jens; Jansen, Olav; Lindner, Thomas ; Gellißen, Susanne.

In: STROKE RES TREAT, Vol. 2021, 9933015, 2021.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Austein, F, Fischer, AC, Fiehler, J, Jansen, O, Lindner, T & Gellißen, S 2021, 'Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment', STROKE RES TREAT, vol. 2021, 9933015. https://doi.org/10.1155/2021/9933015

APA

Austein, F., Fischer, A. C., Fiehler, J., Jansen, O., Lindner, T., & Gellißen, S. (2021). Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment. STROKE RES TREAT, 2021, [9933015]. https://doi.org/10.1155/2021/9933015

Vancouver

Austein F, Fischer AC, Fiehler J, Jansen O, Lindner T , Gellißen S. Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment. STROKE RES TREAT. 2021;2021. 9933015. https://doi.org/10.1155/2021/9933015

Bibtex

@article{81f6aba5663c40f4a33c6d457876f47d,

title = "Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment",

abstract = "Background: Intracerebral hemorrhage (ICH) is a serious complication of endovascular treatment (EVT) in stroke patients with large vessel occlusion (LVO) and associated with increased morbidity and mortality.Aims: Identification of radiological predictors is highly relevant. We investigated the predictive power of computed tomography perfusion (CTP) parameters concerning ICH in patients receiving EVT.Methods: 392 patients with anterior circulation LVO with multimodal CT imaging who underwent EVT were analyzed. CTP parameters were visually evaluated for modified ASPECTS regions and compared between patients without ICH, those with hemorrhagic infarction (HI), and those with parenchymal hematoma (PH) according to the ECASS criteria at follow-up imaging and broken down by ASPECTS regions.Results: 168 received intravenous thrombolysis (IV-rtPA), and 115 developed subsequent ICH (29.3%), of which 74 were classified as HI and 41 as PH. Patients with HI and PH had lower ASPECTS than patients without ICH and worse functional outcome after 90 days (p < 0.05). In 102 of the 115 patients with ICH, the deep middle cerebral artery (MCA) territory was affected with differences between patients without ICH, those with HI, and those with PH regarding cerebral blood volume (CBV) and blood-brain barrier permeability measured as flow extraction product (FED) relative to the contralateral hemisphere (p < 0.05). Patients with PH showed larger perfusion CT infarct core than patients without ICH (p < 0.01).Conclusion: None of the examined CTP parameters was found to be a strong predictor of subsequent ICH. ASPECTS and initial CTP core volume were more reliable and may be useful and even so more practicable to assess the risk of subsequent ICH after EVT.",

author = "Friederike Austein and Fischer, {Antonia Carlotta} and Jens Fiehler and Olav Jansen and Thomas Lindner and Susanne Gelli{\ss}en",

note = "Copyright {\textcopyright} 2021 Friederike Austein et al.",

year = "2021",

doi = "10.1155/2021/9933015",

language = "English",

volume = "2021",

journal = "STROKE RES TREAT",

issn = "2090-8105",

publisher = "Hindawi Publishing Corporation",

}

RIS

TY - JOUR

T1 - Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment

AU - Austein, Friederike

AU - Fischer, Antonia Carlotta

AU - Fiehler, Jens

AU - Jansen, Olav

AU - Lindner, Thomas

AU - Gellißen, Susanne

PY - 2021

Y1 - 2021

N2 - Background: Intracerebral hemorrhage (ICH) is a serious complication of endovascular treatment (EVT) in stroke patients with large vessel occlusion (LVO) and associated with increased morbidity and mortality.Aims: Identification of radiological predictors is highly relevant. We investigated the predictive power of computed tomography perfusion (CTP) parameters concerning ICH in patients receiving EVT.Methods: 392 patients with anterior circulation LVO with multimodal CT imaging who underwent EVT were analyzed. CTP parameters were visually evaluated for modified ASPECTS regions and compared between patients without ICH, those with hemorrhagic infarction (HI), and those with parenchymal hematoma (PH) according to the ECASS criteria at follow-up imaging and broken down by ASPECTS regions.Results: 168 received intravenous thrombolysis (IV-rtPA), and 115 developed subsequent ICH (29.3%), of which 74 were classified as HI and 41 as PH. Patients with HI and PH had lower ASPECTS than patients without ICH and worse functional outcome after 90 days (p < 0.05). In 102 of the 115 patients with ICH, the deep middle cerebral artery (MCA) territory was affected with differences between patients without ICH, those with HI, and those with PH regarding cerebral blood volume (CBV) and blood-brain barrier permeability measured as flow extraction product (FED) relative to the contralateral hemisphere (p < 0.05). Patients with PH showed larger perfusion CT infarct core than patients without ICH (p < 0.01).Conclusion: None of the examined CTP parameters was found to be a strong predictor of subsequent ICH. ASPECTS and initial CTP core volume were more reliable and may be useful and even so more practicable to assess the risk of subsequent ICH after EVT.

AB - Background: Intracerebral hemorrhage (ICH) is a serious complication of endovascular treatment (EVT) in stroke patients with large vessel occlusion (LVO) and associated with increased morbidity and mortality.Aims: Identification of radiological predictors is highly relevant. We investigated the predictive power of computed tomography perfusion (CTP) parameters concerning ICH in patients receiving EVT.Methods: 392 patients with anterior circulation LVO with multimodal CT imaging who underwent EVT were analyzed. CTP parameters were visually evaluated for modified ASPECTS regions and compared between patients without ICH, those with hemorrhagic infarction (HI), and those with parenchymal hematoma (PH) according to the ECASS criteria at follow-up imaging and broken down by ASPECTS regions.Results: 168 received intravenous thrombolysis (IV-rtPA), and 115 developed subsequent ICH (29.3%), of which 74 were classified as HI and 41 as PH. Patients with HI and PH had lower ASPECTS than patients without ICH and worse functional outcome after 90 days (p < 0.05). In 102 of the 115 patients with ICH, the deep middle cerebral artery (MCA) territory was affected with differences between patients without ICH, those with HI, and those with PH regarding cerebral blood volume (CBV) and blood-brain barrier permeability measured as flow extraction product (FED) relative to the contralateral hemisphere (p < 0.05). Patients with PH showed larger perfusion CT infarct core than patients without ICH (p < 0.01).Conclusion: None of the examined CTP parameters was found to be a strong predictor of subsequent ICH. ASPECTS and initial CTP core volume were more reliable and may be useful and even so more practicable to assess the risk of subsequent ICH after EVT.

U2 - 10.1155/2021/9933015

DO - 10.1155/2021/9933015

M3 - SCORING: Journal article

C2 - 34336182

VL - 2021

JO - STROKE RES TREAT

JF - STROKE RES TREAT

SN - 2090-8105

M1 - 9933015

ER -