ABSTRACT
Objective: To explore the predictive effect of microvascular permeability surface (PS) on spontaneous hemorrhagic transformation (HT) in acute ischemic stroke patients. Methods: A retrospective analysis was performed on 43 patients with acute ischemic stroke who underwent CT perfusion imaging (CTPI). Neither arterial thrombolysis nor intravenous thrombolysis was carried out in these patients. The patients were divided into HT group (n=20) and control group (n=23) according to whether HT occurred within 2 weeks after the onset of stroke detected with CT or MRI. Mann-whitney U test was used to compare the differences of CTPI parameters, including PS, cerebral blood volume (CBV) and cerebral blood flow (CBF) between the affected and contralateral areas in HT group, and CTPI parameters of the affected area were also compared between HT and control groups. ROC curve was used to analyze the efficiency of PS value to predict HT. Results: In HT group, PS (Z=-5.410, P<0.001) and CBV (Z=-3.517, P<0.001) of the affected area were higher than those of contralateral area, while CBF (Z=-2.245, P=0.024) of the affected area was lower than that of contralateral area. PS (Z=-5.065, P<0.001) and CBV (Z=-3.458, P=0.001) of the affected area in HT group were higher than those in control group, while there was no statistical difference of CBF (Z=-1.729, P=0.084) of the affected area between HT and control group. ROC analysis showed that the AUC was 0.952 for predicting HT in acute ischemic stroke patients with the threshold of PS as 0.032 4 ml/(100 ml•min). The sensitivity, specificity and accuracy was 90.00%, 82.60% and 86.05%, respectively. Conclusion: PS value can be used to predict HT in patients with acute ischemic stroke, therefore being helpful to appropriate treatments in clinic.
ABSTRACT
Objective To investigate the application of CT microvascular permeability surface (PS) in acute ischemic stroke. Methods Thirty patients suffering from acute or sub-acute cerebral infarction underwent CT perfusion (CTP) combining with CTA. Cerebral hemodynamic parameters (cerebral blood flow [CBF], cerebral blood volume [CBV], time to peak [TTP], PS) between lesions and contralateral side were compared. The manifestation of microvascular hyper permeability were analyzed. Results Significant differences were found in cerebral hemodynamic parameters between the core of cerebral infarction and the contralateral hemisphere (P＜0.05). There was no significant difference in CBF and CBV between the surrounding of cerebral infarction and the contralateral hemisphere, but PS and TTP showed delaying and heightening, the difference was significant (P＜0.05). High-density extravasation of contrast media in infarction zone was observed 30 min after CTP in 3 patients, the value of PS reached (9.20±1.43) ml/100 (ml·min). Conclusion CT microvascular PS may monitor hemorrhagic transformation in acute ischemic stroke, and guide thrombolytic therapy.