Mean transit time on Aquilion ONE and its utilization in patients undergoing acute stroke intervention.
Mean transit time on Aquilion ONE and its utilization in patients undergoing acute stroke intervention.
复制标题
Aquilion ONE 的平均通过时间及其在接受急性中风干预的患者中的使用。
DOI：
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
J. Mocco
中科院分区：
文献类型：
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作者：
H. Dababneh;A. Bashir;W. Guerrero;K. Wilson;M. Hussain;Sara Misthal;W. Morgan;K. Peters;J. Kirmani;J. Mocco
背景
神经影像学技术在识别具有可挽救半影区的患者方面是有益的。我们试图在接受血管内治疗的急性大血管缺血性卒中患者中，使用运行奇异值分解+算法的Aqueolone计算机断层扫描（CT）扫描仪，验证计算机断层扫描灌注（CTP）成像的平均通过时间（MTT）图。
方法
我们对符合以下标准的急诊室就诊的连续患者进行了回顾性分析：1）患有大血管急性缺血性卒中; 2）具有高质量的全脑CTP; 3）接受血管内治疗; 4）在48小时内接受了随访MRI和弥散加权成像（DWI）。设盲的神经科医生、神经放射科医生和神经外科医生使用Vitrea软件使用梗死周边法独立处理图像。
结果
12例患者符合入选标准。在考虑其他共同因素（即，再通率、CT和MRI之间的时间、达到再通的时间和IV t-PA给药）。MTT被重新定义为毛细血管MTT（cMTT），其代表缺氧诱导的血管舒张/收缩影响的毛细血管流动。我们根据再灌注程度将患者分为两组：A）TICI评分为II B或III的患者和B）TICI评分为I或IIa的患者。我们比较了两组，发现与随访MRI相比，再灌注率显著影响MTT上的梗死体积（p值< 0.04）。此外，我们发现平均MTT梗死体积与最终DWI MR体积之间存在强正相关性R（2）= 0.6。此外，平均MTT IC体积为最终平均DWI IC体积的84%。
结论
虽然需要进一步的研究来验证这项回顾性研究，但初步数据表明，cMTT标测图可以成为评估可能受益于积极血管内治疗的急性卒中患者的有价值和准确的工具。
BACKGROUND
Neuroimaging techniques have been beneficial in identifying patients with salvageable penumbra. We sought to validate the mean transit time (MTT) map on computed tomography perfusion (CTP) imaging utilizing an Aquilion ONE computed tomography (CT) scanner running a singular value decomposition plus algorithm in patients with acute large vessel ischemic stroke who underwent endovascular therapy.
METHODS
We conducted a retrospective analysis of consecutive patients presenting to the emergency room who met the following criteria: 1) had a large vessel acute ischemic stroke; 2) had a high-quality whole-brain CTP; 3) treated with endovascular therapy; and 4) received a follow-up MRI with diffusion-weighted imaging (DWI) within 48 h. A blinded neurologist, neuroradiologist, and neurosurgeon utilized the Vitrea software to process the images independently using an infarct perimeter method.
RESULTS
Twelve patients met the inclusion criteria. A comparison was made between the volumes of infarct core (IC) utilizing MTT and DWI after accounting for other co-founding factors (i.e., recanalization rate, time between CT and MRI, time to achieve recanalization, and IV t-PA administration). MTT was redefined as capillary MTT (cMTT) which represented evolving capillary flow influenced by hypoxia induced vasodilation/vasoconstriction. We divided the patients into two groups based on the degree of reperfusion: A) patients with a TICI score of IIb or III and B) patients with a TICI score of I or IIa. We compared the two groups and found that the rate of reperfusion significantly affected the volume of the infarct on MTT when compared with a follow-up MRI (p value < 0.04). Furthermore, we found a strong positive correlation R(2) = 0.6 between the average MTT infarct volume and the final DWI MR volumes. In addition, the averaged MTT IC volumes were 84% of the final averaged DWI IC volumes.
CONCLUSION
Although further studies are required to validate this retrospective study, preliminary data suggest that cMTT maps can be a valuable and accurate tool in the assessment of patients with acute stroke who may benefit from aggressive endovascular therapy.