Diagnostic performance of CT cerebral blood volume colour maps for evaluation of acute infarcts; comparison with diffusion-weighted MRI within 12 hours of major stroke onset
Diagnostic performance of CT cerebral blood volume colour maps for evaluation of acute infarcts; comparison with diffusion-weighted MRI within 12 hours of major stroke onset
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DOI：
10.1016/j.neurad.2016.10.005
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发表时间：
2017-02-01
影响因子：
3.5
通讯作者：
Abdelghany, Hosny S.
中科院分区：
文献类型：
--
作者：
Abdelgawad, Enas A.;Higazi, Mahmoud M.;Abdelghany, Hosny S.
背景和目的：缺血性卒中治疗的最新进展增加了通过成像确定缺血性损害限度的重要性。一些研究认为，CTP是一种很有前途的技术，可以区分缺血核心和半暗带。在本研究中，我们试图评价CTP-CBV彩图作为急性脑梗塞的标志物的诊断性能，并与弥散加权成像进行比较。材料和方法：我们回顾分析了48例CTA患者，他们在发病12小时内被证实为严重缺血性卒中，他们在1小时内进行了弥散加权成像和CTP检查，而不分先后顺序。计算了DWI的大小。计算CBV彩图诊断急性脑梗塞的灵敏度、特异度、PPV和NPV。结果：CBV彩图漏诊了大量DWI显示的小面积心肌梗死，其总体诊断准确率为62.5%，而对DWI大小为70毫升的患者诊断敏感性较低(38.5%)。曲线下面积为0.79。弥散加权像大小是CBV彩色图异常的唯一预测因子(P=0.005)。结论：在临床实践中，假定弥散加权像与基于脑血流图的核心图像的直接等价性对于个体患者可能是不现实的。CBV彩图对急性脑梗塞有很高的特异性，但缺乏足够的敏感性；尤其是对小面积的脑梗塞。(C)2016年爱思唯尔·马森SAS。版权所有。
Background and purpose: Recent developments in treatment of ischemic stroke increased importance of defining limits of ischemic insult by imaging. Some studies postulated that CTP is a promising technique, which can discriminate between ischemic core and penumbra. In this study, we sought to evaluate diagnostic performance of CTP-CBV colour maps, regarded as a marker of acute infarct; in comparison with DWI.Materials and methods: We retrospectively analyzed 48 patients with CTA proved major ischemic stroke within 12 hours of onset, they had DWI and CTP exams within 1 hour of each other, regardless of order. DWI sizes were calculated. Sensitivity, specificity, PPV and NPV of CBV colour maps for identification of acute infarcts were calculated. ROC curve was constructed.Results: CBV colour maps missed a lot of small infarcts that were identified by DWI with an overall diagnostic accuracy of (62.5%) and low sensitivity (38.5%) for patients whom DWI size < 70 mL. Area under curve was 0.79. DWI size was an only predictor of abnormal CBV colour maps (P = 0.005).Conclusions: Assuming direct equivalence of DWI and CBV-based core might be unrealistic for individual patients in clinical practice. CBV colour maps are highly specific for acute infarcts, but with lack of sufficient sensitivity; particularly for small sized infarcts. (C) 2016 Elsevier Masson SAS. All rights reserved.