ArticleScientific reports2016
Defining Core and Penumbra in Ischemic Stroke: A Voxel- and Volume-Based Analysis of Whole Brain CT Perfusion.
Article in Scientific reports, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Assessing the diagnostic accuracy of CT perfusion: a systematic review.Frontiers in neurology · 2023Pooled it
- Fingolimod enhances the efficacy of delayed alteplase administration in acute ischemic stroke by promoting anterograde reperfusion and retrograde collateral flow.Annals of neurology · 2018Trial
- Intermittent hypoxia ameliorates behavioral deficits and exerts neurorestoration in a mouse photothrombotic stroke model.Theranostics · 2026Article
- A multimodal multitask deep learning model for predicting stroke lesion and functional outcomes using 4D CTP imaging and clinical metadata.Scientific reports · 2025Article
- Research progress on remote ischemic conditioning for improving prognosis of patients with acute ischemic stroke.Biochemistry and biophysics reports · 2025Review
- Feasibility of Deuterium Metabolic Magnetic Resonance Spectroscopy for the Investigation of Ischemia and Reperfusion in Rat Brain Slices Perfused Ex Vivo.NMR in biomedicine · 2025Article
- Updates in Intravenous Thrombolysis Treatment for Acute Ischemic Stroke in Asian Populations.Aging and disease · 2025Review
- Infarct core growth rate and 90-day outcomes in ischemic stroke: subgroup analysis based on onset-to-recanalization time.Frontiers in neurology · 2025Article
- Out of the core: the impact of focal ischemia in regions beyond the penumbra.Frontiers in cellular neuroscience · 2024Review
- Perfusion deficits in thrombolysis-treated acute ischemic stroke patients with negative or positive diffusion-weighted imaging.BMC neurology · 2023Observational
- Reperfusion Therapies in Acute Ischemic Stroke Beyond the Conventional Time Window: A Narrative Review.Cureus · 2023Review
- Comprehensive Venous Outflow Predicts Functional Outcomes in Patients with Acute Ischemic Stroke Treated by Thrombectomy.AJNR. American journal of neuroradiology · 2023Article
- A fluorescein angiography-based computer-aided algorithm for assessing the retinal vasculature in diabetic retinopathy.Eye (London, England) · 2023Article
- Ischemic Lesion Growth in Patients with a Persistent Target Mismatch After Large Vessel Occlusion.Clinical neuroradiology · 2023Article
- End to end stroke triage using cerebrovascular morphology and machine learning.Frontiers in neurology · 2023Article
- Filling Defect of Ipsilateral Transverse Sinus in Acute Large Artery Occlusion.Frontiers in neurology · 2022Article
- Peroxisome Proliferator-Activated Receptor-Gamma (PPAR-ɣ): Molecular Effects and Its Importance as a Novel Therapeutic Target for Cerebral Ischemic Injury.Neurochemical research · 2021Review
- Automatic segmentation, feature extraction and comparison of healthy and stroke cerebral vasculature.NeuroImage. Clinical · 2021Article
- Antegrade Blood Flow on 4-Dimensional Computed Tomography Angiography Predict Stroke Subtype in Patients With Acute Large Artery Occlusion.Journal of the American Heart Association · 2020Article
- Ischemic lesion growth in acute stroke: Water uptake quantification distinguishes between edema and tissue infarct.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2020Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Whole brain computed tomography perfusion (CTP) has the potential to select eligible patients for reperfusion therapy. We aimed to find the optimal thresholds on baseline CTP for ischemic core and penumbra in acute ischemic stroke. We reviewed patients with acute ischemic stroke in the anterior circulation, who underwent baseline whole brain CTP, followed by intravenous thrombolysis and perfusion imaging at 24 hours. Patients were divided into those with major reperfusion (to define the ischemic core) and minimal reperfusion (to define the extent of penumbra). Receiver operating characteristic (ROC) analysis and volumetric consistency analysis were performed separately to determine the optimal threshold by Youden's Index and mean magnitude of volume difference, respectively. From a series of 103 patients, 22 patients with minimal-reperfusion and 47 with major reperfusion were included. Analysis revealed delay time ≥ 3 s most accurately defined penumbra (AUC = 0.813; 95% CI, 0.812-0.814, mean magnitude of volume difference = 29.1 ml). The optimal threshold for ischemic core was rCBF ≤ 30% within delay time ≥ 3 s (AUC = 0.758; 95% CI, 0.757-0.760, mean magnitude of volume difference = 10.8 ml). In conclusion, delay time ≥ 3 s and rCBF ≤ 30% within delay time ≥ 3 s are the optimal thresholds for penumbra and core, respectively. These results may allow the application of the mismatch on CTP to reperfusion therapy.
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