ArticlePloS one2017
High-permeability region size on perfusion CT predicts hemorrhagic transformation after intravenous thrombolysis in stroke.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Early Predictive Accuracy of Machine Learning for Hemorrhagic Transformation in Acute Ischemic Stroke: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2025Pooled it
- Blood-Brain Barrier Disruption and Hemorrhagic Transformation in Acute Ischemic Stroke: Systematic Review and Meta-Analysis.Frontiers in neurology · 2020Pooled it
- Perfusion CT for prediction of hemorrhagic transformation in acute ischemic stroke: a systematic review and meta-analysis.European radiology · 2019Pooled it
- Symptomatic Intracranial Hemorrhage After Endovascular Stroke Treatment: External Validation of Prediction Models.Stroke · 2023Trial
- CT perfusion ischemic core predicts PH-2 hemorrhagic transformation following intravenous alteplase bridging treatment prior to endovascular thrombectomy.Therapeutic advances in neurological disorders · 2026Article
- Functional Outcomes and Symptomatic Intracranial Hemorrhage After Endovascular Treatment in Acute Vertebrobasilar Artery Occlusions: External Validation of Prediction Models.Stroke (Hoboken, N.J.) · 2024Article
- Value of pre-intervention CT perfusion imaging in acute ischemic stroke prognosis.Diagnostic and interventional radiology (Ankara, Turkey) · 2021Article
- Editorial: Intracranial Bleeding After Reperfusion Therapy in Acute Ischemic Stroke.Frontiers in neurology · 2021Article
- Galectin-3 Mediated Inflammatory Response Contributes to Neurological Recovery by QiShenYiQi in Subacute Stroke Model.Frontiers in pharmacology · 2021Article
- Prognostic Value of a New Integrated Parameter-Both Collateral Circulation and Permeability Surface-in Hemorrhagic Transformation of Middle Cerebral Artery Occlusion Acute Ischemic Stroke: Retrospective Cohort Study.Frontiers in aging neuroscience · 2021Article
- Pathophysiology of Blood-Brain Barrier Permeability Throughout the Different Stages of Ischemic Stroke and Its Implication on Hemorrhagic Transformation and Recovery.Frontiers in neurology · 2020Review
- Article
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveBlood-brain barrier (BBB) permeability has been proposed as a predictor of hemorrhagic transformation (HT) after tissue plasminogen activator (tPA) administration; however, the reliability of perfusion computed tomography (PCT) permeability imaging for predicting HT is uncertain. We aimed to determine the performance of high-permeability region size on PCT (HPrs-PCT) in predicting HT after intravenous tPA administration in patients with acute stroke.
methodsWe performed a multimodal CT protocol (non-contrast CT, PCT, CT angiography) to prospectively study patients with middle cerebral artery occlusion treated with tPA within 4.5 hours of symptom onset. HT was graded at 24 hours using the European-Australasian Acute Stroke Study II criteria. ROC curves selected optimal volume threshold, and multivariate logistic regression analysis identified predictors of HT.
resultsThe study included 156 patients (50% male, median age 75.5 years). Thirty-seven (23,7%) developed HT [12 (7,7%), parenchymal hematoma type 2 (PH-2)]. At admission, patients with HT had lower platelet values, higher NIHSS scores, increased ischemic lesion volumes, larger HPrs-PCT, and poorer collateral status. The negative predictive value of HPrs-PCT at a threshold of 7mL/100g/min was 0.84 for HT and 0.93 for PH-2. The multiple regression analysis selected HPrs-PCT at 7mL/100g/min combined with platelets and baseline NIHSS score as the best model for predicting HT (AUC 0.77). HPrs-PCT at 7mL/100g/min was the only independent predictor of PH-2 (OR 1, AUC 0.68, p = 0.045).
conclusionsHPrs-PCT can help predict HT after tPA, and is particularly useful in identifying patients at low risk of developing HT.
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