Computed tomography perfusion and computed tomography angiography for prediction of clinical outcomes in ischemic stroke patients after thrombolysis

• Published in: Neural regeneration research 2017, Vol.12 (1), p.103-108
• Main Authors: Pan, Jia-wei, Yu, Xiang-rong, Zhou, Shu-yi, Wang, Jian-hong, Zhang, Jun, Geng, Dao-ying, Zhang, Tian-yu, Cheng, Xin, Ling, Yi-feng, Dong, Qiang
• Format: Article
• Language: English
• Subjects: Analysis; Anticoagulants; Blood; Carotid arteries; CAT scans; Clinical outcomes; Health aspects; Ischemia; Medical imaging; nerve regeneration; ischemic stroke; 256-slice whole-brain CT perfusion; infarct core; penumbra; CT perfusion mismatch; CT angiography; vessel stenosis; intravenous thrombolysis; 24-hour National Institution of Health Stroke Scale; 3-month modified Rankin Scale; neural regeneration; Patients; Prognosis; Short term; Software; Stroke; Tomography; Veins & arteries; 临床疗效; 成像方法; 溶栓; 脑卒中; 血流灌注; 血管造影; 预测
• ISSN: 1673-5374; 1876-7958
• DOI: 10.4103/1673-5374.198994

Cerebral blood perfusion and cerebrovascular lesions are important factors that can affect the therapeutic efficacy of thrombolysis.At present,the majority of studies focus on assessing the accuracy of lesion location using imaging methods before treatment,with less attention to predictions of outcomes after thrombolysis.Thus,in the present study,we assessed the efficacy of combined computed tomography（CT） perfusion and CT angiography in predicting clinical outcomes after thrombolysis in ischemic stroke patients.The study included 52 patients who received both CT perfusion and CT angiography.Patients were grouped based on the following criteria to compare clinical outcomes：（1） thrombolytic and non-thrombolytic patients,（2） thrombolytic patients with CT angiography showing the presence or absence of a vascular stenosis,（3） thrombolytic patients with CT perfusion showing the presence or absence of hemodynamic mismatch,and（4） different CT angiography and CT perfusion results.Short-term outcome was assessed by the 24-hour National Institution of Health Stroke Scale score change.Long-term outcome was assessed by the 3-month modified Rankin Scale score.Of 52 ischemic stroke patients,29 were treated with thrombolysis and exhibited improved short-term outcomes compared with those without thrombolysis treatment（23 patients）.Patients with both vascular stenosis and blood flow mismatch（13 patients） exhibited the best short-term outcome,while there was no correlation of long-term outcome with CT angiography or CT perfusion findings.These data suggest that combined CT perfusion and CT angiography are useful for predicting short-term outcome,but not long-term outcome,after thrombolysis.