J 2017

Permeability surface area product analysis in malignant brain edema prediction – A pilot study

VOLNÝ, Ondřej, Petra CIMFLOVÁ, T.-Y. LEE, B. K. MENON, C. D. D'ESTERRE et. al.

Basic information

Original name

Permeability surface area product analysis in malignant brain edema prediction – A pilot study

Authors

VOLNÝ, Ondřej (203 Czech Republic, guarantor, belonging to the institution), Petra CIMFLOVÁ (203 Czech Republic, belonging to the institution), T.-Y. LEE (124 Canada), B. K. MENON (124 Canada) and C. D. D'ESTERRE (124 Canada)

Edition

Journal of the Neurological Sciences, Amsterdam, Elsevier Science BV, 2017, 0022-510X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30103 Neurosciences

Country of publisher

Netherlands

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.448

RIV identification code

RIV/00216224:14110/17:00096427

Organization unit

Faculty of Medicine

DOI

UT WoS

000401210500043

Keywords in English

Ischemic stroke; Malignant brain edema; CT perfusion; Permeability surface area product

Tags

Tags

International impact, Reviewed
Změněno: 20/3/2018 13:51, Soňa Böhmová

Abstract

V originále

Background and purpose Using an extended CT perfusion acquisition (150s), we sought to determine the association between perfusion parameters and malignant edema after ischemic stroke. Methods Patients (from prospective study PROVE-IT, NCT02184936) with terminal internal carotid artery ± proximal middle cerebral occlusion were involved. CTA was assessed for clot location and status of leptomeningeal collaterals. The following CTP parameters were calculated within the ischemic territory and contralaterally: permeability surface area product (PS), cerebral blood flow (CBF) and cerebral blood volume (CBV). PS was calculated using the adiabatic approximation to the Johnson and Wilson model. Outcome was evaluated by midline shift and infarction volume on follow-up imaging. Results Of 200 patients enrolled, 7 patients (3.5%) had midline shift >= 5 mm (2 excluded for poor-quality scans). Five patients with midline shift and 5 matched controls were analysed. There was no significant difference in mean PS, CBF and CBV within the ischemic territory between the two groups. A CBV threshold of 1.7 ml/100 g had the highest AUC = 0.72, 95% CI = 0.54–0.90 for early midline shift prediction, sensitivity and specificity were 0.83 and 0.67 respectively. Conclusion Our preliminary results did not show significant differences in permeability surface area analysis if analysed for complete ischemic region. CBV parameter had the highest accuracy and there was a trend for the mean PS values for midline shift prediction.