title: Computed tomography perfusion and computed tomography angiography for prediction of clinical outcomes in ischemic stroke patients after thrombolysis.
abstract: Cerebral blood perfusion and cerebrovascular lesions are important factors that can affect the therapeutic efficacy of thrombolysis. At present, the majority of studies focus on assessing the accuracy of lesion location using imaging methods before treatment, with less attention to predictions of outcomes after thrombolysis. Thus, in the present study, we assessed the efficacy of combined computed tomography (CT) perfusion and CT angiography in predicting clinical outcomes after thrombolysis in ischemic stroke patients. The study included 52 patients who received both CT perfusion and CT angiography. Patients were grouped based on the following criteria to compare clinical outcomes: (1) thrombolytic and non-thrombolytic patients, (2) thrombolytic patients with CT angiography showing the presence or absence of a vascular stenosis, (3) thrombolytic patients with CT perfusion showing the presence or absence of hemodynamic mismatch, and (4) different CT angiography and CT perfusion results. Short-term outcome was assessed by the 24-hour National Institution of Health Stroke Scale score change. Long-term outcome was assessed by the 3-month modified Rankin Scale score. Of 52 ischemic stroke patients, 29 were treated with thrombolysis and exhibited improved short-term outcomes compared with those without thrombolysis treatment (23 patients). Patients with both vascular stenosis and blood flow mismatch (13 patients) exhibited the best short-term outcome, while there was no correlation of long-term outcome with CT angiography or CT perfusion findings. These data suggest that combined CT perfusion and CT angiography are useful for predicting short-term outcome, but not long-term outcome, after thrombolysis.
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Jia-Wei
authors.initials: JW
authors.lastname: Pan
authors.affiliation: Department of Radiology, Zhuhai Hospital of Jinan University, Zhuhai People's Hospital, Zhuhai, Guangdong Province, China.
authors.forename: Xiang-Rong
authors.initials: XR
authors.lastname: Yu
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Shu-Yi
authors.initials: SY
authors.lastname: Zhou
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Jian-Hong
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Jun
authors.identifier: 0000-0003-1849-9199
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Dao-Ying
authors.identifier: 0000-0002-6121-7866
authors.initials: DY
authors.lastname: Geng
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Tian-Yu
authors.initials: TY
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Cheng
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Yi-Feng
authors.initials: YF
authors.lastname: Ling
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Dong
keywords: 24-hour National Institution of Health Stroke Scale; 256-slice whole-brain CT perfusion; 3-month modified Rankin Scale; CT angiography; CT perfusion mismatch; infarct core; intravenous thrombolysis; ischemic stroke; nerve regeneration; neural regeneration; penumbra; vessel stenosis