Clinical application value of brain CT perfusion imaging in the treatment of acute ischemic stroke thrombolytic therapy

Abstract

Clinical application value of CT perfusion (CTP) imaging in the treatment of acute ischemic stroke (AIS) thrombolytic therapy was investigated. Retrospective analysis of 185 suspected AIS patients in Liaocheng Brain Hospital from April 2012 to December 2017 were involved. We observed the non-contrast CT (NCCT) and CTP in the diagnosis of AIS patients, and recorded as well as compared CTP parameters of AIS patients. The National Institute of Health Stroke Scale (NIHSS) rating was conducted, and the correlation between the prognosis of NIHSS scores and CTP parameters was investigated. A total of 177 patients were diagnosed with AIS. The sensitivity levels of CTP examination for diagnosis of AIS patients was significantly higher than that of the NCCT examination (P<0.050). The diagnostic compliance rates of CTP examination was significantly higher than that of the NCCT examination (P<0.050). The cerebral blood volume (CBV) in the abnormal perfusion area was significantly lower than that in the mirror side zone (t=21.160, P<0.001). The prognostic NIHSS score was negatively correlated with CBV in patients with thrombolytic therapy (r=−0.912, P<0.001). The cerebral blood flow (CBF) in the abnormal perfusion zone was significantly lower than that in the mirror side zone (t=19.170, P<0.001). The prognosis of patients with thrombolytic therapy was negatively correlated with CBF (r=−0.915, P<0.001). The mean transit time (MTT) in the abnormal perfusion zone was higher than that in the mirror side zone (t=13.480, P<0.001). NIHSS scores were obtained 3 months after thrombolytic therapy and found that the prognostic NIHSS scores were positively correlated with MTT (r=0.887, P<0.001). The results indicated that brain CTP has a high diagnostic value for intravenous thrombolytic therapy in AIS and there was a significant correlation between the prognosis scores of patients. Thus, it is worthy of being promoted in the clinical diagnosis and treatment of AIS patients.

Prognosis with non-contrast CT and CT Perfusion imaging in thrombolysis-treated acute ischemic stroke

“…A large number of reports showed that CTP related parameters can detect cerebral ischemic injury in the early stage and could provide an effective basis for clinical diagnosis and treatment decision [30,31]. Decreased CBF may indicate that cerebral circulation reserve is decompensated, and even further develops into cerebral infarction [32]. A previous study found that core infarct volume was associated with clinical prognostic indicators on the 14th and 90th day, which further reinforced our results [33].…”

Predictive Value of CT Brain Perfusion Studies in Acute Ischemic Infarct Taking MRI Stroke Protocol As Gold Standard

“…CT perfusion is a strong diagnostic modality for accurate assessment of volumetric core/penumbra mismatch ratios, thus predicting the volume of potentially rescuable tissue at risk that can be saved from recanalization therapy [ 17 , 18 ]. It not only aids in the selection of stroke patients for reperfusion treatment but also has good prognostic value [ 19 ]. CT may not only help in the selection of candidates for endovascular intervention in conjunction with tPA therapy, but it can also help in those patients in whom the use of tPA is contraindicated [ 20 , 21 ].…”

Predictive Value of CT Perfusion in Hemorrhagic Transformation after Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

“…CTP has been widely used in patients with AIS and can evaluate ischemic penumbra visually [36,37]. CTP has the advantages of relative rapidity and wide applicability [38,39]. In addition to CTP, some studies have reported the diagnostic value of magnetic resonance imaging (MRI) in AIS [40][41][42][43].…”