Single Subcortical Infarct: Pathomechanism Assessed by Thin-Section Computed Tomography Perfusion

• Published in: Journal of stroke and cerebrovascular diseases 2017-07, Vol.26 (7), p.1440-1448
• Main Authors: Shin, Dong Hoon, MD, Klotz, Ernst, PhD, Kim, Eung Yeop, MD
• Format: Article
• Language: English
• Subjects: Aged; atherosclerotic; Cardiovascular; Cerebral infarction; Cerebral Infarction - diagnostic imaging; Cerebral Infarction - etiology; Cerebral Infarction - physiopathology; cerebral small vessel diseases; Cerebrovascular Circulation; Chi-Square Distribution; Computed Tomography Angiography - methods; Diffusion Magnetic Resonance Imaging; Female; Humans; Male; Middle Aged; Multidetector Computed Tomography - methods; Multivariate Analysis; Neurology; Odds Ratio; perfusion imaging; Perfusion Imaging - methods; plaque; Predictive Value of Tests; Prognosis; Radiographic Image Interpretation, Computer-Assisted; Retrospective Studies
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2017.03.017

Introduction The pathomechanism of a single subcortical infarct (SSI) may be better determined by assessing the perfusion status between parent artery and ischemic lesion. We aimed to compare the classifications into branch atheromatous disease (BAD) versus non-BAD based on diffusion-weighted imaging (DWI) or computed tomography perfusion (CTP), and to test whether a CTP-based classification improves the predicting power for progression in SSI (PSSI) compared to that by DWI. Methods We enrolled 109 consecutive patients with SSI examined by whole-supratentorial brain CTP and follow-up DWI. Time-to-drain (TTD) maps were calculated from 1-mm dynamic CTP data. BAD was assumed when either the ischemic lesion extended to the basal surface of the parent artery on axial DWI or the hypoperfused area (TTD ≥ 5 seconds) was