ArticleTranslational stroke research2023
Assessment of Irreversible Tissue Injury in Extensive Ischemic Stroke-Potential of Quantitative Cerebral Perfusion.
Article in Translational stroke research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Net water uptake as a predictive neuroimaging marker for acute ischemic stroke outcomes: a meta-analysis.European radiology · 2024Pooled it
- Oedema reduction mediates thrombectomy benefit in large core stroke: secondary analysis of the TENSION trial.European stroke journal · 2026Trial
- Mediation of ghost infarct core on prognosis by venous outflow and net water uptake after stroke thrombectomy.European radiology · 2026Article
- Using NIRS-Based Spectroscopy for the Comparison of Cerebral Net-Water Uptake and Microcirculation in Posttraumatic Penumbra in Severe Traumatic Brain Injury Patients.Academic radiology · 2026Article
- Current perspective in acute ischemic stroke: net water uptake and imaging-guided selection as bridges to personalized, tissue-based care.Frontiers in neurology · 2025Article
- Haemorrhage after thrombectomy with adjuvant thrombolysis in unknown onset stroke depends on high early lesion water uptake.Stroke and vascular neurology · 2024Article
- High relative cerebral blood volume is associated with good long term clinical outcomes in acute ischemic stroke: a retrospective cohort study.BMC neurology · 2024Article
- Overestimation of the Ischemic Core Is Associated With Higher Core Lesion Volume and Degree of Reperfusion After Thrombectomy.Radiology · 2024Article
- Discrepancy Between Ischemic Changes Observed on Non-Enhanced Computed Tomography and Perfusion Imaging: Implications for Decision-Making in Treatment.Journal of stroke · 2024Article
- A dynamic nomogram for predict individual risk of malignant brain edema after endovascular thrombectomy in acute ischemic stroke.Scientific reports · 2024Article
- Comparison of Cerebral Saturation and Brain Net Water Uptake After Moderate Traumatic Brain Injury.Advances in experimental medicine and biology · 2024Article
- Investigating Neurologic Improvement After IV Thrombolysis: The Effect of Time From Stroke Onset vs Imaging-Based Tissue Clock.Neurology · 2023Observational
- Cerebral Net Water Uptake in Posttraumatic Cerebral Ischemia.Advances in experimental medicine and biology · 2023Article
- Net water uptake within the ischemic penumbra predicts the presence of the midline shift in patients with acute ischemic stroke.Frontiers in neurology · 2023Article
- On Net Water Uptake in Posttraumatic Ischemia Foci.Advances in experimental medicine and biology · 2023Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Computed tomography perfusion (CTP) is used as a tool to select ischemic stroke patients for endovascular treatment (EVT) and is currently investigated in the setting of extensive stroke with low Alberta Stroke Program Early CT scores (ASPECTS). The purpose of this study was to perform a comprehensive quantitative analysis of cerebral blood flow within the ischemic lesion compared to threshold-derived core lesion volumes. We hypothesized that the degree of cerebral blood volume (CBV) reduction within the ischemic lesion is predictive of irreversible tissue injury and functional outcome in patients with low ASPECTS. Ischemic stroke patients with an ASPECTS ≤ 5 who received multimodal CT on admission and underwent thrombectomy were analyzed. The ischemic lesion on CTP was identified, and CTP-derived parameters were measured as absolute means within the lesion and relative to the physiological perfusion measured in a contralateral region of interest. The degree of irreversible tissue injury was assessed using quantitative net water uptake (NWU). Functional endpoint was good outcome defined as modified Rankin Scale (mRS) scores 0-3 at day 90. One hundred eleven patients were included. The median core lesion volume was 71 ml (IQR: 25-107), and the median quantitative NWU was 9.5% (IQR: 6-13). Relative CBV (rCBV) reduction and ASPECTS at baseline were independently associated with NWU in multivariable linear regression analysis (ß: 12.4, 95%CI: 6.0-18.9, p < 0.0001) and (ß: - 0.78, 95% CI: - 1.53 to - 0.02; p = 0.045), respectively. Furthermore, rCBV was significantly associated with good outcome in patients with core volumes > 50 ml (OR: 0.16, 95% CI: 0.05-0.49, p = 0.001). Our study shows that rCBV reduction serves as an early surrogate for increase of NWU as a marker of irreversible tissue injury and lesion progression. Thus, the analysis of rCBV reduction within ischemic lesions may add another dimension to acute stroke triage in addition to core volumes or ASPECTS as indicators of the infarct extent and viability.
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