دورية أكاديمية
أعرض في EDS

Penumbra pattern assessment in acute stroke patients: comparison of quantitative and non-quantitative methods in whole brain CT perfusion.

التفاصيل البيبلوغرافية
العنوان: Penumbra pattern assessment in acute stroke patients: comparison of quantitative and non-quantitative methods in whole brain CT perfusion.
المؤلفون: Thierfelder KM; Department of Clinical Radiology, Ludwig-Maximilians-University of Munich Hospitals, Munich, Germany., von Baumgarten L; Department of Neurology, Ludwig-Maximilians-University of Munich Hospitals, Munich, Germany., Baumann AB; Department of Clinical Radiology, Ludwig-Maximilians-University of Munich Hospitals, Munich, Germany., Meinel FG; Department of Clinical Radiology, Ludwig-Maximilians-University of Munich Hospitals, Munich, Germany., Helck AD; Department of Clinical Radiology, Ludwig-Maximilians-University of Munich Hospitals, Munich, Germany., Opherk C; Department of Neurology, Ludwig-Maximilians-University of Munich Hospitals, Munich, Germany; Institute for Stroke and Dementia Research, Ludwig-Maximilians-University of Munich Hospitals, Munich, Germany., Straube A; Department of Neurology, Ludwig-Maximilians-University of Munich Hospitals, Munich, Germany., Reiser MF; Department of Clinical Radiology, Ludwig-Maximilians-University of Munich Hospitals, Munich, Germany., Sommer WH; Department of Clinical Radiology, Ludwig-Maximilians-University of Munich Hospitals, Munich, Germany.
المصدر: PloS one [PLoS One] 2014 Aug 21; Vol. 9 (8), pp. e105413. Date of Electronic Publication: 2014 Aug 21 (Print Publication: 2014).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Perfusion Imaging* , Tomography, X-Ray Computed*, Brain/*metabolism , Stroke/*diagnostic imaging , Stroke/*metabolism , Tetraspanins/*metabolism, Adult ; Aged ; Aged, 80 and over ; Brain/pathology ; Female ; Humans ; Infarction, Middle Cerebral Artery/diagnostic imaging ; Infarction, Middle Cerebral Artery/metabolism ; Male ; Middle Aged ; Stroke/pathology ; Time Factors
مستخلص: Background and Purpose: While penumbra assessment has become an important part of the clinical decision making for acute stroke patients, there is a lack of studies measuring the reliability and reproducibility of defined assessment techniques in the clinical setting. Our aim was to determine reliability and reproducibility of different types of three-dimensional penumbra assessment methods in stroke patients who underwent whole brain CT perfusion imaging (WB-CTP).
Materials and Methods: We included 29 patients with a confirmed MCA infarction who underwent initial WB-CTP with a scan coverage of 100 mm in the z-axis. Two blinded and experienced readers assessed the flow-volume-mismatch twice and in two quantitative ways: Performing a volumetric mismatch analysis using OsiriX imaging software (MM(VOL)) and visual estimation of mismatch (MM(EST)). Complementarily, the semiquantitative Alberta Stroke Programme Early CT Score for CT perfusion was used to define mismatch (MM(ASPECTS)). A favorable penumbral pattern was defined by a mismatch of ≥ 30% in combination with a cerebral blood flow deficit of ≤ 90 ml and an MM(ASPECTS) score of ≥ 1, respectively. Inter- and intrareader agreement was determined by Kappa-values and ICCs.
Results: Overall, MM(VOL) showed considerably higher inter-/intrareader agreement (ICCs: 0.751/0.843) compared to MM(EST) (0.292/0.749). In the subgroup of large (≥ 50 mL) perfusion deficits, inter- and intrareader agreement of MM(VOL) was excellent (ICCs: 0.961/0.942), while MM(EST )interreader agreement was poor (0.415) and intrareader agreement was good (0.919). With respect to penumbra classification, MM(VOL) showed the highest agreement (interreader agreement: 25 agreements/4 non-agreements/κ: 0.595; intrareader agreement 27/2/0.833), followed by MM(EST) (22/7/0.471; 23/6/0.577), and MM(ASPECTS) (18/11/0.133; 21/8/0.340).
Conclusion: The evaluated approach of volumetric mismatch assessment is superior to pure visual and ASPECTS penumbra pattern assessment in WB-CTP and helps to precisely judge the extent of 3-dimensional mismatch in acute stroke patients.
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المشرفين على المادة: 0 (TSPAN33 protein, human)
0 (Tetraspanins)
تواريخ الأحداث: Date Created: 20140822 Date Completed: 20150514 Latest Revision: 20211021
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC4140765
DOI: 10.1371/journal.pone.0105413
PMID: 25144396
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0105413