 visitant ::
identificació
|
|||||||||||||||
|
Cerca | Lliura | Ajuda | Servei de Biblioteques | Sobre el DDD | Català English Español | |||||||||
| Pàgina inicial > Articles > Articles publicats > High-permeability region size on perfusion CT predicts hemorrhagic transformation after intravenous thrombolysis in stroke |
(Institut d'Investigació Biomèdica de Girona) (Institut d'Investigació Biomèdica de Girona) (Universitat de Girona. Departament d'Informàtica, Matemàtica Aplicada i Estadística) (Institut d'Investigació Biomèdica de Girona) (Institut d'Investigació Biomèdica de Girona) (Neurovascular Imaging Research Core and UCLA Stroke Center) (Instituto de Investigación Biomédica de A Coruña)
| Data: | 2017 |
| Resum: | Objective. Blood-brain barrier (BBB) permeability has been proposed as a predictor of hemorrhagic transformation (HT) after tissue plasminogen activator (tPA) administration; however, the reliability of perfusion computed tomography (PCT) permeability imaging for predicting HT is uncertain. We aimed to determine the performance of high-permeability region size on PCT (HPrs- PCT) in predicting HT after intravenous tPA administration in patients with acute stroke. Methods. We performed a multimodal CT protocol (non-contrast CT, PCT, CT angiography) to prospectively study patients with middle cerebral artery occlusion treated with tPA within 4. 5 hours of symptom onset. HT was graded at 24 hours using the European-Australasian Acute Stroke Study II criteria. ROC curves selected optimal volume threshold, and multivariate logistic regression analysis identified predictors of HT. Results. The study included 156 patients (50% male, median age 75. 5 years). Thirty-seven (23,7%) developed HT [12 (7,7%), parenchymal hematoma type 2 (PH-2)]. At admission, patients with HT had lower platelet values, higher NIHSS scores, increased ischemic lesion volumes,larger HPrs-PCT, and poorer collateral status. The negative predictive value of HPrs-PCT at a threshold of 7mL/100g/min was 0. 84 for HT and 0. 93 for PH-2. The multiple regression analysis selected HPrs-PCT at 7mL/100g/min combined with platelets and baseline NIHSS score as the best model for predicting HT (AUC 0. 77). HPrs-PCT at 7mL/100g/min was the only independent predictor of PH-2 (OR 1, AUC 0. 68, p = 0. 045). Conclusions. HPrs-PCT can help predict HT after tPA, and is particularly useful in identifying patients at low risk of developing HT. |
| Ajuts: | Instituto de Salud Carlos III PI10/01309 Instituto de Salud Carlos III PI13/02258 Instituto de Salud Carlos III RD12/0014/0001 Instituto de Salud Carlos III RD16/0019/0004 |
| Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.  |
| Llengua: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Publicat a: | PloS one, Vol. 12 Núm. 11 (november 2017) , p. 1-12, ISSN 1932-6203 |
