ArticleAnnals of neurology2020
Permeability Measures Predict Hemorrhagic Transformation after Ischemic Stroke.
Article in Annals of neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Risk factors of hemorrhagic transformation in acute ischaemic stroke: A systematic review and meta-analysis.Frontiers in neurology · 2023Pooled it
- Trial
- Review
- Impact of Asymptomatic Intracranial Hemorrhage on Outcome After Endovascular Stroke Treatment.Annals of clinical and translational neurology · 2026Article
- Article
- Serum EphA4 is Associated with both Parenchymal Hematoma and Increased Blood-Brain Barrier Permeability after Ischemic Stroke.Neurocritical care · 2026Article
- Commentary: insights and future directions from a CT perfusion-based study on POCD risk prediction.International journal of surgery (London, England) · 2026Article
- Blood-brain barrier vulnerability and microcirculatory dysfunction as predictors of hemorrhagic transformation after endovascular treatment in acute ischemic stroke.Frontiers in aging neuroscience · 2026Article
- A quantitative CT perfusion-derived online dynamic nomogram for predicting hemorrhagic transformation after intravenous thrombolysis in acute ischemic stroke.European journal of radiology open · 2025Article
- Neuroinflammation and acute ischemic stroke: impact on translational research and clinical care.Frontiers in surgery · 2025Review
- Exploring ischemic core growth rate and endovascular therapy benefit in large core patients.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024Article
- Blood-Brain Barrier Permeability and Kinetics of Inflammatory Markers in Acute Stroke Patients Treated With Thrombectomy.Neurology · 2023Article
- Prediction of hemorrhagic transformation via pre-treatment CT radiomics in acute ischemic stroke patients receiving endovascular therapy.The British journal of radiology · 2023Article
- Predictive Value of CT Perfusion in Hemorrhagic Transformation after Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.Brain sciences · 2023Review
- Imaging blood-brain barrier dysfunction: A state-of-the-art review from a clinical perspective.Frontiers in aging neuroscience · 2023Review
- Neuroimaging is the new "spatial omic": multi-omic approaches to neuro-inflammation and immuno-thrombosis in acute ischemic stroke.Seminars in immunopathology · 2023Review
- Minimal Imaging Requirements.Journal of neuroendovascular therapy · 2023Review
- Review
- Angong Niuhuang Wan reduces hemorrhagic transformation and mortality in ischemic stroke rats with delayed thrombolysis: involvement of peroxynitrite-mediated MMP-9 activation.Chinese medicine · 2022Article
- Radiomics-based infarct features on CT predict hemorrhagic transformation in patients with acute ischemic stroke.Frontiers in neuroscience · 2022Article
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Authors and funding
13 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe sought to examine the diagnostic utility of existing predictors of any hemorrhagic transformation (HT) and compare them with new perfusion imaging permeability measures in ischemic stroke patients receiving alteplase only.
methodsA pixel-based analysis of pretreatment CT perfusion (CTP) was undertaken to define the optimal CTP permeability thresholds to predict the likelihood of HT. We then compared previously proposed predictors of HT using regression analyses and receiver operating characteristic curve analysis to produce an area under the curve (AUC). We compared AUCs using χ
resultsFrom 5 centers, 1,407 patients were included in this study; of these, 282 had HT. The cohort was split into a derivation cohort (1,025, 70% patients) and a validation cohort (382 patients or 30%). The extraction fraction (E) permeability map at a threshold of 30% relative to contralateral had the highest AUC at predicting any HT (derivation AUC 0.85, 95% confidence interval [CI], 0.79-0.91; validation AUC 0.84, 95% CI 0.77-0.91). The AUC improved when permeability was assessed within the acute perfusion lesion for the E maps at a threshold of 30% (derivation AUC 0.91, 95% CI 0.86-0.95; validation AUC 0.89, 95% CI 0.86-0.95). Previously proposed associations with HT and parenchymal hematoma showed lower AUC values than the permeability measure.
interpretationIn this large multicenter study, we have validated a highly accurate measure of HT prediction. This measure might be useful in clinical practice to predict hemorrhagic transformation in ischemic stroke patients before receiving alteplase alone. ANN NEUROL 2020;88:466-476.
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