ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2014
Clinical use of computed tomographic perfusion for the diagnosis and prediction of lesion growth in acute ischemic stroke.
Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Comparative accuracy of CT perfusion in diagnosing acute ischemic stroke: A systematic review of 27 trials.PloS one · 2017Pooled it
- Effect of Comprehensive Nursing Intervention on the Effect of CT-Guided Intravenous Thrombolysis in Acute Cerebral Infarction.Journal of healthcare engineering · 2022Trial
- MultiModal craniocerebral diagnose based on 3D CT and image reports.Scientific reports · 2025Article
- Pictorial Review on Imaging Findings in Cerebral CTP in Patients with Acute Stroke and Its Mimics: A Primer for General Radiologists.Diagnostics (Basel, Switzerland) · 2023Review
- Clinical translation of amide proton transfer (APT) MRI for ischemic stroke: a systematic review (2003-2020).Quantitative imaging in medicine and surgery · 2021Review
- An integrative multivariate approach for predicting functional recovery using magnetic resonance imaging parameters in a translational pig ischemic stroke model.Neural regeneration research · 2021Article
- Penumbra volume predicts unfavorable outcome in patients with acute minor stroke or transient ischemic attack.Journal of the Chinese Medical Association : JCMA · 2020Article
- DWI-Based Algorithm to Predict Disability in Patients Treated with Thrombectomy for Acute Stroke.AJNR. American journal of neuroradiology · 2020Observational
- Defining Ischemic Core in Acute Ischemic Stroke Using CT Perfusion: A Multiparametric Bayesian-Based Model.AJNR. American journal of neuroradiology · 2019Article
- Human Neural Stem Cell Extracellular Vesicles Improve Recovery in a Porcine Model of Ischemic Stroke.Stroke · 2018Article
- Intra-arterial thrombectomy: does invasive treatment lead to better outcomes than intravenous thrombolysis alone?Current cardiology reports · 2015Review
- Brain imaging in acute ischemic stroke—MRI or CT?Current neurology and neuroscience reports · 2015Review
- Cerebral CT angiography and CT perfusion in acute stroke detection: a systematic review of diagnostic value.Quantitative imaging in medicine and surgery · 2014Review
- Acute stroke imaging: recent updates.Stroke research and treatment · 2013Article
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundComputed tomography perfusion (CTP) mapping in research centers correlates well with diffusion-weighted imaging (DWI) lesions and may accurately differentiate the infarct core from ischemic penumbra. The value of CTP in real-world clinical practice has not been fully established. We investigated the yield of CTP-derived cerebral blood volume (CBV) and mean transient time (MTT) for the detection of cerebral ischemia and ischemic penumbra in a sample of acute ischemic stroke (AIS) patients.
methodsWe studied 165 patients with initial clinical symptoms suggestive of AIS. All patients had an initial noncontrast head CT, CTP, CT angiogram (CTA), and follow-up magnetic resonance imaging (MRI) of the brain. The obtained perfusion images were used for image processing. CBV, MTT, and DWI lesion volumes were visually estimated and manually traced. Statistical analysis was conducted using R and SAS software.
resultsAll normal DWI sequences had normal CBV and MTT studies (N = 89). Seventy-three patients had acute DWI lesions. CBV was abnormal in 23.3% and MTT was abnormal in 42.5% of these patients. There was a high specificity (91.8%) but poor sensitivity (40.0%) for MTT maps predicting positive DWI. The Spearman correlation was significant between MTT and DWI lesions (ρ = 0.66; P > .0001) only for abnormal MTT and DWI lesions >0 cc. CBV lesions did not correlate with final DWI.
conclusionsIn real-world use, acute imaging with CTP did not predict stroke or DWI lesions with sufficient accuracy. Our findings argue against the use of CTP for screening AIS patients until real-world implementations match the accuracy reported from specialized research centers.
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