医学
灌注扫描
灌注
脑血流
基底动脉
置信区间
放射科
人口
脑血容量
冲程(发动机)
血管造影
心脏病学
核医学
内科学
机械工程
环境卫生
工程类
作者
Lars-Peder Pallesen,Johannes Gerber,Imanuel Dzialowski,E.J. Hoeven,Patrik Michel,Thomas Pfefferkorn,Christoph Ozdoba,L. Jaap Kappelle,Baerbel Wiedemann,Andrei Khomenko,Ale Algra,Michael D. Hill,Ruediger von Kummer,Andrew M. Demchuk,Wouter J. Schonewille,Volker Puetz
摘要
ABSTRACT BACKGROUND AND PURPOSE The posterior circulation Acute Stroke Prognosis Early CT Score (pc‐APECTS) applied to CT angiography source images (CTA‐SI) predicts the functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS). We assessed the diagnostic and prognostic impact of pc‐ASPECTS applied to perfusion CT (CTP) in the BASICS registry population. METHODS We applied pc‐ASPECTS to CTA‐SI and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) parameter maps of BASICS patients with CTA and CTP studies performed. Hypoattenuation on CTA‐SI, relative reduction in CBV or CBF, or relative increase in MTT were rated as abnormal. RESULTS CTA and CTP were available in 27/592 BASICS patients (4.6%). The proportion of patients with any perfusion abnormality was highest for MTT (93%; 95% confidence interval [CI], 76%‐99%), compared with 78% (58%‐91%) for CTA‐SI and CBF, and 46% (27%‐67%) for CBV ( P < .001). All 3 patients with a CBV pc‐ASPECTS < 8 compared to 6/23 patients with a CBV pc‐ASPECTS ≥ 8 had died at 1 month (RR 3.8; 95% CI, 1.9‐7.6). CONCLUSION CTP was performed in a minority of the BASICS registry population. Perfusion disturbances in the posterior circulation were most pronounced on MTT parameter maps. CBV pc‐ASPECTS < 8 may indicate patients with high case fatality.
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