Abstract
Objective: To explore the value of whole-brain perfusion parameters combined with multiphase
computed tomography angiography (MP-CTA) in predicting the hemorrhagic transformation
(HT) of ischemic stroke. Methods: A total of 64 patients with ischemic stroke who underwent noncontrast computed tomography,
computed tomography perfusion imaging, and computed tomography angiography before
treatment from August 2017 to June 2019 were included retrospectively. The perfusion
parameters cerebral blood volume (CBV), cerebral blood flow (CBF), time to peak (TTP),
mean transit time (MTT), time to maximum (Tmax), and permeability surface (PS) were
measured by postprocessing software (Advantage Workstation 4.7 (Revolution, GE Healthcare,
USA)), and their ratios between the healthy and affect side relative CBV, relative
CBF, relative time to peak (rTTP), relative mean transit time (rMTT), relative Tmax,
and relative permeability surface (rPS) were calculated. The differences in perfusion
parameters between the HT group and the non-HT group were evaluated. The collateral
circulation scores and HT rates were assessed by MP-CTA. Receiver operating characteristic
curves were drawn to analyze the diagnostic efficiency of valuable parameters and
their correlations with HT. The rate of HT in different treatments were compared.
Results: The CBV values in the HT group were lower than those in the non-HT group (P < .05), while the TTP, MTT, Tmax, PS, rTTP, rMTT, and rPS values in the HT group
were higher than those in the non-HT group (P < .05). PS (r = .63, area under curve = .881) and rPS (r = .52, area under curve = .814)
were significantly correlated with HT. The combination of perfusion parameters and
the MP-CTA scores can improve the diagnostic efficiency (area under curve = .891).
The HT rate in the group with poor collateral (64.29%) was higher than that in the
group with good collateral (11.11%). Conclusions: Whole-brain perfusion parameters and MP-CTA scores have important application value
in assessing the HT risk of ischemic stroke patients before treatment.
Key Words
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Article info
Publication history
Published online: February 14, 2020
Accepted:
January 22,
2020
Received in revised form:
January 18,
2020
Received:
November 18,
2019
Footnotes
Funding: Supported by Chongqing Science and Technology Foundation (grant no:cstc2019jscx-msxmX0161).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104690
Copyright
© 2020 Elsevier Inc. All rights reserved.
