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논문 기본 정보

자료유형
학술저널
저자정보
Peter B. Sporns (Department of Neuroradiology Clinic of Radiology & Nuclear Medicine University Hospital Basel B) Marco Höhne (Department of Radiology University Hospital of Münster Westfaelische Wilhelms-University of Münster) Lennart Meyer (Department of Neurology with Institute of Translational Neurology University of Münster Münster Ger) Christos Krogias (Department of Neurology St. Josef-Hospital Ruhr University Bochum Bochum Germany) Volker Puetz (Department of Neurology University Hospital Carl Gustav Carus Dresden Germany) Kolja M. Thierfelder (Department of Radiology and Institute of Diagnostic and Interventional Radiology University Medical) Marco Duering (Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering University of Basel B) Daniel Kaiser (Neurovascular Center Dresden, University Hospital Carl Gustav Carus, Dresden, Germany) Sönke Langner (Department of Radiology and Institute of Diagnostic and Interventional Radiology University Medical) Alex Brehm (Department of Neuroradiology Clinic of Radiology & Nuclear Medicine University Hospital Basel B) Lukas T. Rotkopf (Department of Radiology German Cancer Research Center Heidelberg Germany) Wolfgang G. Kunz (Department of Radiology University Hospital LMU Munich Munich Germa) Jens Fiehler (Department of Diagnostic and Interventional Neuroradiology University Medical Center Hamburg-Eppend) Walter Heindel (Department of Radiology, University Hospital of Munster, Westfaelische Wilhelms-University of Munst) Peter Schramm (Department of Neuroradiology University Medical Center Schleswig-Holstein Lübeck Germany) Heinz Wiendl (Department of Neurology with Institute of Translational Neurology University of Münster Münster Ger) Heike Minnerup (Institute of Epidemiology and Social Medicine University of Münster Münster Germany) Marios Nikos Psychogios (Department of Neuroradiology Clinic of Radiology & Nuclear Medicine University Hospital Basel B) André Kemmling (Department of Diagnostic and Interventional Neuroradiology University Medical Center Marburg Marbur) Jens Minnerup (Department of Neurology with Institute of Translational Neurology, University of Munster, Munster,)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제24권 제3호
발행연도
2022.9
수록면
390 - 395 (6page)

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Background and Purpose Many patients with stroke cannot receive intravenous thrombolysis because the time of symptom onset is unknown. We tested whether a simple method of computed tomography (CT)-based quantification of water uptake in the ischemic tissue can identify patients with stroke onset within 4.5 hours. Methods This retrospective analysis of the MissPerfeCT study (August 2009 to November 2017) includes consecutive patients with known onset of symptoms from seven tertiary stroke centers. We developed a simplified algorithm based on region of interest (ROI) measurements to quantify water uptake of the ischemic lesion and thereby quantify time of symptom onset within and beyond 4.5 hours. Perfusion CT was used to identify ischemic brain tissue, and its density was measured in non-contrast CT and related to the density of the corresponding area of the contralateral hemisphere to quantify lesion water uptake. Results Of 263 patients, 204 (77.6%) had CT within 4.5 hours. Water uptake was significantly lower in patients with stroke onset within (6.7%; 95% confidence interval [CI], 6.0% to 7.4%) compared to beyond 4.5 hours (12.7%; 95% CI, 10.7% to 14.7%). The area under the curve for distinguishing these patient groups according to percentage water uptake was 0.744 with an optimal cut-off value of 9.5%. According to this cut-off the positive predictive value was 88.8%, sensitivity was 73.5%, specificity 67.8%, negative predictive value was 42.6%. Conclusions Ischemic stroke patients with unknown time of symptom onset can be identified as being within a timeframe of 4.5 hours using a ROI-based method to assess water uptake on admission non-contrast head CT.

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