Kremenova Karin, Lukavsky Jiri, Holesta Michal, Peisker Tomas, Lauer David, Weichet Jiri, Malikova Hana
Radiology Department, Third Faculty of Medicine, Charles University, Faculty Hospital Kralovske Vinohrady, 100 34 Prague, Czech Republic.
Institute of Psychology, Czech Academy of Sciences, 110 00 Prague, Czech Republic.
Diagnostics (Basel). 2022 Sep 22;12(10):2290. doi: 10.3390/diagnostics12102290.
CT perfusion (CTP) is used for the evaluation of brain tissue viability in patients with acute ischemic stroke (AIS). We studied the accuracy of three different syngo.via software (SW) settings for acute ischemic core estimation in predicting the final infarct volume (FIV). The ischemic core was defined as follows: Setting A: an area with cerebral blood flow (CBF) < 30% compared to the contralateral healthy hemisphere. Setting B: CBF < 20% compared to contralateral hemisphere. Setting C: area of cerebral blood volume (CBV) < 1.2 mL/100 mL. We studied 47 AIS patients (aged 68 ± 11.2 years) with large vessel occlusion in the anterior circulation, treated in the early time window (up to 6 h), who underwent technically successful endovascular thrombectomy (EVT). FIV was measured on MRI performed 24 ± 2 h after EVT. In general, all three settings correlated with each other; however, the absolute agreement between acute ischemic core volume on CTP and FIV on MRI was poor; intraclass correlation for all three settings was between 0.64 and 0.69, root mean square error of the individual observations was between 58.9 and 66.0. Our results suggest that using CTP syngo.via SW for prediction of FIV in AIS patients in the early time window is not appropriate.
CT灌注成像（CTP）用于评估急性缺血性卒中（AIS）患者的脑组织活力。我们研究了三种不同的syngo.via软件（SW）设置在预测最终梗死体积（FIV）时对急性缺血核心估计的准确性。缺血核心定义如下：设置A：与对侧健康半球相比，脑血流量（CBF）<30%的区域。设置B：与对侧半球相比，CBF<20%。设置C：脑血容量（CBV）<1.2 mL/100 mL的区域。我们研究了47例在前循环中发生大血管闭塞、在早期时间窗（长达6小时）内接受治疗且技术上成功进行血管内血栓切除术（EVT）的AIS患者（年龄68±11.2岁）。在EVT后24±2小时进行的MRI上测量FIV。总体而言，所有三种设置相互之间都存在相关性；然而，CTP上的急性缺血核心体积与MRI上的FIV之间的绝对一致性较差；所有三种设置的组内相关性在0.64至0.69之间，个体观察值的均方根误差在58.9至66.0之间。我们的结果表明，在早期时间窗内使用CTP syngo.via软件预测AIS患者的FIV是不合适的。
