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ABSTRACT: Introduction
We investigated whether baseline CT angiography (CTA) and CT perfusion (CTP) in acute ischemic stroke could improve prediction of infarct presence and infarct volume on follow-up imaging.Methods
We analyzed 906 patients with suspected anterior circulation stroke from the prospective multicenter Dutch acute stroke study (DUST). All patients underwent baseline non-contrast CT, CTA, and CTP and follow-up non-contrast CT/MRI after 3 days. Multivariable regression models were developed including patient characteristics and non-contrast CT, and subsequently, CTA and CTP measures were added. The increase in area under the curve (AUC) and R (2) was assessed to determine the additional value of CTA and CTP.Results
At follow-up, 612 patients (67.5%) had a detectable infarct on CT/MRI; median infarct volume was 14.8 mL (interquartile range (IQR) 2.8-69.6). Regarding infarct presence, the AUC of 0.82 (95% confidence interval (CI) 0.79-0.85) for patient characteristics and non-contrast CT was improved with addition of CTA measures (AUC 0.85 (95% CI 0.82-0.87); p?ConclusionIn the acute stage, CTA and CTP have additional value over patient characteristics and non-contrast CT for predicting infarct presence and infarct volume on follow-up imaging. These findings could be applied for patient selection in future trials on ischemic stroke treatment.
SUBMITTER: van Seeters T
PROVIDER: S-EPMC4819789 | biostudies-literature | 2016 Apr
REPOSITORIES: biostudies-literature
van Seeters Tom T Biessels Geert Jan GJ Kappelle L Jaap LJ van der Schaaf Irene C IC Dankbaar Jan Willem JW Horsch Alexander D AD Niesten Joris M JM Luitse Merel J A MJ Majoie Charles B L M CB Vos Jan Albert JA Schonewille Wouter J WJ van Walderveen Marianne A A MA Wermer Marieke J H MJ Duijm Lucien E M LE Keizer Koos K Bot Joseph C J JC Visser Marieke C MC van der Lugt Aad A Dippel Diederik W J DW Kesselring F Oskar H W FO Hofmeijer Jeannette J Lycklama À Nijeholt Geert J GJ Boiten Jelis J van Rooij Willem Jan WJ de Kort Paul L M PL Roos Yvo B W E M YB Meijer Frederick J A FJ Pleiter C Constantijn CC Mali Willem P T M WP van der Graaf Yolanda Y Velthuis Birgitta K BK
Neuroradiology 20160114 4
<h4>Introduction</h4>We investigated whether baseline CT angiography (CTA) and CT perfusion (CTP) in acute ischemic stroke could improve prediction of infarct presence and infarct volume on follow-up imaging.<h4>Methods</h4>We analyzed 906 patients with suspected anterior circulation stroke from the prospective multicenter Dutch acute stroke study (DUST). All patients underwent baseline non-contrast CT, CTA, and CTP and follow-up non-contrast CT/MRI after 3 days. Multivariable regression models ...[more]