Perfusion-CT Assessment of Infarct Core and Penumbra
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- Max Wintermark
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Adam E. Flanders
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Birgitta Velthuis
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Reto Meuli
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Maarten van Leeuwen
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Dorit Goldsher
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Carissa Pineda
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Joaquin Serena
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Irene van der Schaaf
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Annet Waaijer
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- James Anderson
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Gary Nesbit
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Igal Gabriely
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Victoria Medina
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Ana Quiles
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Scott Pohlman
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Marcel Quist
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Pierre Schnyder
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Julien Bogousslavsky
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- William P. Dillon
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
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- Salvador Pedraza
- From the Department of Radiology, Neuroradiology Section (M.W., W.P.D.), University of California, San Francisco; the Departments of Radiology (V.M., A.Q., S.P.) and Neurology (J.S.), Hospital Doctor Josep Trueta, Girona, Spain; the Departments of Radiology (A.E.F.) and Neurology (C.P.), Thomas Jefferson University Hospital, Philadelphia, Pa; the Department of Radiology (B.V., M.v.L., I.v.d.S., A.W.), University Medical Center Utrecht, The Netherlands; the Departments of Radiology (R.M., P.S.) and...
Bibliographic Information
- Other Title
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- Receiver Operating Characteristic Curve Analysis in 130 Patients Suspected of Acute Hemispheric Stroke
Abstract
<jats:p> <jats:bold> <jats:italic>Background and Purpose—</jats:italic> </jats:bold> Different definitions have been proposed to define the ischemic penumbra from perfusion-CT (PCT) data, based on parameters and thresholds tested only in small pilot studies. The purpose of this study was to perform a systematic evaluation of all PCT parameters (cerebral blood flow, volume [CBV], mean transit time [MTT], time-to-peak) in a large series of acute stroke patients, to determine which (combination of) parameters most accurately predicts infarct and penumbra. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods—</jats:italic> </jats:bold> One hundred and thirty patients with symptoms suggesting hemispheric stroke ≤12 hours from onset were enrolled in a prospective multicenter trial. They all underwent admission PCT and follow-up diffusion-weighted imaging/fluid-attenuated inversion recovery (DWI/FLAIR); 25 patients also underwent admission DWI/FLAIR. PCT maps were assessed for absolute and relative reduced CBV, reduced cerebral blood flow, increased MTT, and increased time-to-peak. Receiver-operating characteristic curve analysis was performed to determine the most accurate PCT parameter, and the optimal threshold for each parameter, using DWI/FLAIR as the gold standard. </jats:p> <jats:p> <jats:bold> <jats:italic>Results—</jats:italic> </jats:bold> The PCT parameter that most accurately describes the tissue at risk of infarction in case of persistent arterial occlusion is the relative MTT (area under the curve=0.962), with an optimal threshold of 145%. The PCT parameter that most accurately describes the infarct core on admission is the absolute CBV (area under the curve=0.927), with an optimal threshold at 2.0 ml×100 g <jats:sup>−1</jats:sup> . </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusion—</jats:italic> </jats:bold> In a large series of 130 patients, the optimal approach to define the infarct and the penumbra is a combined approach using 2 PCT parameters: relative MTT and absolute CBV, with dedicated thresholds. </jats:p>
Journal
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- Stroke
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Stroke 37 (4), 979-985, 2006-04
Ovid Technologies (Wolters Kluwer Health)
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Details 詳細情報について
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- CRID
- 1364233271218237440
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- ISSN
- 15244628
- 00392499
- http://id.crossref.org/issn/00392499
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- Data Source
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- Crossref