Computed Tomography Perfusion Data for Acute Ischemic Stroke Evaluation Using Rapid Software: Pitfalls of Automated Postprocessing

Computed tomography perfusion (CTP) is increasingly used to determine treatment eligibility for acute ischemic stroke patients. Automated postprocessing of raw CTP data is routinely used, but it can fail. In reviewing 176 consecutive acute ischemic stroke patients, failures occurred in 20 patients (11%) during automated postprocessing by the RAPID software. Failures were caused by motion (n = 11, 73%), streak artifacts (n = 2, 13%), and poor contrast bolus arrival (n = 2, 13%). Stroke physicians should review CTP results with care before they are being integrated in their decision-making process.
Source: Journal of Computer Assisted Tomography - Category: Radiology Tags: Neuroradiology Source Type: research

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Publication date: March 2020Source: Journal of Vascular and Interventional Radiology, Volume 31, Issue 3, SupplementAuthor(s): R. Wang, K. Chang, H. Zhou, J. Wu, G. Cohan, M. Jayaraman, R. Huang, J. Boxerman, L. Yang, F. Hui, J. Woo, H. Bai
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
Objective: To explore the value of whole-brain perfusion parameters combined with multiphase computed tomography angiography (MP-CTA) in predicting the hemorrhagic transformation (HT) of ischemic stroke. Methods: A total of 64 patients with ischemic stroke who underwent noncontrast computed tomography, computed tomography perfusion imaging, and computed tomography angiography before treatment from August 2017 to June 2019 were included retrospectively. The perfusion parameters cerebral blood volume (CBV), cerebral blood flow (CBF), time to peak (TTP), mean transit time (MTT), time to maximum (Tmax), and permeability surfac...
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
CONCLUSION: A high level of CEUS perfusion and increased serum FFA levels are indicative of vulnerable carotid plaques, which may be useful for the prediction of stroke in patients with carotid artery disease. PMID: 32039838 [PubMed - as supplied by publisher]
Source: Clinical Hemorheology and Microcirculation - Category: Hematology Authors: Tags: Clin Hemorheol Microcirc Source Type: research
ConclusionOur everyday clinical practice experience suggests 9.8  % of consecutive AIS patients present in the 4.5–9 h window and 2.2 % adhere to EXTEND neuroimaging eligibility criteria for IVT. Only 1.3% of AIS is eligible for IVT according to EXTEND neuroimaging and clinical eligibility criteria.
Source: Neuroradiology - Category: Radiology Source Type: research
Conclusions: There is no justification for the use of reperfusion procedures in acute ischaemic stroke in the anterior circulation in patients with initially unfavourable multimodal computed tomography scores. PMID: 31908703 [PubMed]
Source: Videosurgery and Other Miniinvasive Techniques - Category: Surgery Tags: Wideochir Inne Tech Maloinwazyjne Source Type: research
ConclusionAdding CTP and/or a delayed-phase CTA to NCCT with arterial-phase CTA improves the decision-maker ’s confidence level and creates a trend towards a lower threshold for mechanical thrombectomy.
Source: Neuroradiology - Category: Radiology Source Type: research
Temporary middle cerebral artery occlusion (MCAO) in sheep allows modeling of acute large vessel occlusion stroke and subsequent vessel recanalization. However, rapid and precise imaging-based assessment of vessel occlusion and the resulting perfusion deficit during MCAO still represents an experimental challenge. Here, we tested feasibility and suitability of a strategy for MCAO verification and perfusion deficit assessment. We also compared the extent of the initial perfusion deficit and subsequent lesion size for different MCAO durations. The rete mirabile prevents reliable vascular imaging investigation of middle cereb...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion: This case exemplifies the potential of tenecteplase in achieving swift reperfusion in patients with large vessel occlusion associated with a substantial mismatch penumbral pattern.
Source: The Neurologist - Category: Neurology Tags: Case Report/Case Series Source Type: research
Imaging protocols for acute ischemic stroke varies significantly from center to center leading to challenges in research translation. We aimed to assess the inter-rater reliability of collateral grading systems derived from dynamic computed tomography angiography (CTA) and an optimized multiphase CTA and, to analyze the association of the two CTA modalities with CT perfusion (CTP) compartments by comparing the accuracy of dynamic CTA (dCTA) and optimized multiphase CTA (omCTA) in identifying CT perfusion (CTP) target mismatch patients. Acute ischemic stroke patients with a proximal large vessel occlusion who underwent whol...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Publication date: Available online 16 October 2019Source: Epilepsy &BehaviorAuthor(s): Giada Pauletto, Francesco Bax, Gian Luigi Gigli, Simone Lorenzut, Lorenzo Verriello, Elisa Corazza, Mariarosaria ValenteAbstractAim of the studyThe aim of the study was to evaluate the clinical characteristics of patients with previous stroke (either ischemic or hemorrhagic), who developed status epilepticus (SE) mimicking a stroke relapse.Materials and methodsWe performed a retrospective cohort study of patients brought to hospital by the emergency service between December 2016 and January 2018 with a stroke code as possible candida...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
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