CT Perfusion and Multiphase CT Angiography in Malignant Brain Edema Prediction in Patients with Acute Ischemic Stroke

Authors: O. Volný 1,2;  P. Cimflová 1,3;  C. D. D’esterre 4
Authors‘ workplace: ICRC – Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně 1;  I. neurologická klinika LF MU a FN u sv. Anny v Brně 2;  Klinika zobrazovacích metod LF MU a FN u sv. Anny v Brně 3;  Calgary Stroke Program, Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Canada 4
Published in: Cesk Slov Neurol N 2016; 79/112(2): 213-217
Category: Short Communication
doi: 10.14735/amcsnn2016213

Podpořeno z Evropského regionálního rozvojového fondu –  Projekt FNUSA- ICRC (CZ.1.05/ 1.1.00/ 02.0123), Evropského sociálního fondu a státního rozpočtu České republiky.
Rádi bychom vyjádřili poděkování dr. Bijoy Menon MD MSc. (Hotchkiss Brain Institute, University of Calgary, Canada) a prof. Ting Lee PhD (Imaging Research Labs, Robarts Research Institute, Ontario, Canada) za poskytnutí přístupu k databázi pacientů, za cenné rady, vedení a pomoc při zpracování perfuzních dat, a doc. MU Dr. Robertovi Mikulíkovi, Ph.D., za cenné rady a odborné vedení.


We explore the predictive value of CT perfusion parameters (permeability surface area, cerebral blood flow, cerebral blood volume) and multiphase CT angiography (clot localization, leptomeningeal collaterals and dural sinuses morphology) in the development of malignant brain oedema in patients with acute proximal occlusion of the middle cerebral artery. Patients from the multicentre prospective study PROVE-IT (Precise and Rapid assessment of collaterals using multi-phase CTA in the triage of patients with acute ischemic stroke for IV or IA Therapy; n = 200) were analysed. Primary outcome was evaluated by midline shift ≥ 5 mm on a follow-up CT/MRI. A CBV threshold of 1.76 ml/100 g had the highest sensitivity and specificity of for the midline shift. There was no significant difference between the two groups in analysed CT perfusion parameters calculated for the entire ischemic region.

Key words:
acute ischemic stroke – brain oedema – CT perfusion – CTA angiography – dural sinuses

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


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