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B-0281 - Haemodynamic disturbances in CT perfusion (CTP) for infarct core volume prediction during acute Ischaemic stroke (AIS) in large vessel multiple occlusion

E. Puglielli, R. Lattanzi, G. Esposito, V. Di Egidio; Teramo/IT Type: Scientific Paper
Area of Interests: Neuroradiology brain, Emergency, Interventional vascular
Imaging Techniques: CT-Quantitative, CT, CT-Angiography
Procedures: Computer Applications-3D, Technical aspects, Observer performance
Special Focuses: Ischemia / Infarction, Image verification, Embolism / Thrombosis
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Purpose: To evaluate the impact of hemodynamic disturbances due to multiple intra- and/or extracranial vessel occlusions upon automated CT perfusion analysis tool during AIS. Neuroimaging in acute stroke aims at diagnosing the condition as early as possible and assessing the extent of parenchymal perfusion a[...]

Methods and materials: We review our database retrospectively (876 pts) for all cases of endovascular treatment of AIS (from April 2009 to September 2016), with anterior circulation occlusion, baseline CTP and full recanalization (mTICI III) (114pts). The infarct core was accurately measured using automated normalized, th[...]

Results: CT Angiography can well define the occlusion site, depict arterial state, grade collateral blood flow, and characterize atherosclerotic status. Comparison between multiple 68.4% (78/114) and non multiple 31.5% (36/114) occlusion groups revealed similar baseline ischemic core (21±19 vs. 18±24cm3;p=0.[...]

Conclusion: Automated CTP imaging is not significantly influenced by presence of intra- or extracranial carotid steno-occlusive disease in large vessel AIS and thus may be useful to select patients who will benefit from endovascular reperfusion therapy.

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References: Davis S, Donnan GA Cerebrovasc Time Is Penumbra: Imaging, Selection and Outcome. The Johann Jacob Wepfer Award 2014. Dis. 2014 Sep 16;38(1):59-72. Sabarudin A, Subramaniam C, Sun Z Cerebral CT angiography and CT perfusion in acute stroke detection: a systematic review of diagnostic value. Quant Imag[...]

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