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Additional diagnostic value of computed tomography perfusion for detection of acute ischemic stroke in the posterior circulation.
van der Hoeven, Erik J R J; Dankbaar, Jan Willem; Algra, Ale; Vos, Jan Albert; Niesten, Joris M; van Seeters, Tom; van der Schaaf, Irene C; Schonewille, Wouter J; Kappelle, L Jaap; Velthuis, Birgitta K.
Afiliação
  • van der Hoeven EJ; From the Departments of Radiology (E.J.R.J.v.d.H., J.A.V.) and Neurology (W.J.S.), Sint Antonius Hospital, Nieuwegein, the Netherlands; and Department of Radiology, Brain Center Rudolf Magnus (J.W.D., J.M.N., T.v.S., I.C.v.d.S., B.K.V.), Department Neurology and Neurosurgery (L.J.K., A.A.), and Juli
  • Dankbaar JW; From the Departments of Radiology (E.J.R.J.v.d.H., J.A.V.) and Neurology (W.J.S.), Sint Antonius Hospital, Nieuwegein, the Netherlands; and Department of Radiology, Brain Center Rudolf Magnus (J.W.D., J.M.N., T.v.S., I.C.v.d.S., B.K.V.), Department Neurology and Neurosurgery (L.J.K., A.A.), and Juli
  • Algra A; From the Departments of Radiology (E.J.R.J.v.d.H., J.A.V.) and Neurology (W.J.S.), Sint Antonius Hospital, Nieuwegein, the Netherlands; and Department of Radiology, Brain Center Rudolf Magnus (J.W.D., J.M.N., T.v.S., I.C.v.d.S., B.K.V.), Department Neurology and Neurosurgery (L.J.K., A.A.), and Juli
  • Vos JA; From the Departments of Radiology (E.J.R.J.v.d.H., J.A.V.) and Neurology (W.J.S.), Sint Antonius Hospital, Nieuwegein, the Netherlands; and Department of Radiology, Brain Center Rudolf Magnus (J.W.D., J.M.N., T.v.S., I.C.v.d.S., B.K.V.), Department Neurology and Neurosurgery (L.J.K., A.A.), and Juli
  • Niesten JM; From the Departments of Radiology (E.J.R.J.v.d.H., J.A.V.) and Neurology (W.J.S.), Sint Antonius Hospital, Nieuwegein, the Netherlands; and Department of Radiology, Brain Center Rudolf Magnus (J.W.D., J.M.N., T.v.S., I.C.v.d.S., B.K.V.), Department Neurology and Neurosurgery (L.J.K., A.A.), and Juli
  • van Seeters T; From the Departments of Radiology (E.J.R.J.v.d.H., J.A.V.) and Neurology (W.J.S.), Sint Antonius Hospital, Nieuwegein, the Netherlands; and Department of Radiology, Brain Center Rudolf Magnus (J.W.D., J.M.N., T.v.S., I.C.v.d.S., B.K.V.), Department Neurology and Neurosurgery (L.J.K., A.A.), and Juli
  • van der Schaaf IC; From the Departments of Radiology (E.J.R.J.v.d.H., J.A.V.) and Neurology (W.J.S.), Sint Antonius Hospital, Nieuwegein, the Netherlands; and Department of Radiology, Brain Center Rudolf Magnus (J.W.D., J.M.N., T.v.S., I.C.v.d.S., B.K.V.), Department Neurology and Neurosurgery (L.J.K., A.A.), and Juli
  • Schonewille WJ; From the Departments of Radiology (E.J.R.J.v.d.H., J.A.V.) and Neurology (W.J.S.), Sint Antonius Hospital, Nieuwegein, the Netherlands; and Department of Radiology, Brain Center Rudolf Magnus (J.W.D., J.M.N., T.v.S., I.C.v.d.S., B.K.V.), Department Neurology and Neurosurgery (L.J.K., A.A.), and Juli
  • Kappelle LJ; From the Departments of Radiology (E.J.R.J.v.d.H., J.A.V.) and Neurology (W.J.S.), Sint Antonius Hospital, Nieuwegein, the Netherlands; and Department of Radiology, Brain Center Rudolf Magnus (J.W.D., J.M.N., T.v.S., I.C.v.d.S., B.K.V.), Department Neurology and Neurosurgery (L.J.K., A.A.), and Juli
  • Velthuis BK; From the Departments of Radiology (E.J.R.J.v.d.H., J.A.V.) and Neurology (W.J.S.), Sint Antonius Hospital, Nieuwegein, the Netherlands; and Department of Radiology, Brain Center Rudolf Magnus (J.W.D., J.M.N., T.v.S., I.C.v.d.S., B.K.V.), Department Neurology and Neurosurgery (L.J.K., A.A.), and Juli
Stroke ; 46(4): 1113-5, 2015 Apr.
Article em En | MEDLINE | ID: mdl-25744516
ABSTRACT
BACKGROUND AND

PURPOSE:

Detection of acute infarction in the posterior circulation is challenging. We aimed to determine the additional value of tomograpy (CT) perfusion to noncontrast CT and CT angiography source images for infarct detection and localization in patients suspected of acute ischemic posterior circulation stroke.

METHODS:

Patients with suspected acute ischemic posterior circulation stroke were selected from the Dutch acute Stroke Trial (DUST) study. Patients underwent noncontrast CT, CT angiography, and CT perfusion within 9 hours after stroke onset and CT or MRI on follow-up. Images were evaluated for signs and location of ischemia. Discrimination of 3 hierarchical logistic regression models (noncontrast CT [A], added CT angiography source images [B], and CT perfusion [C]) was compared with C-statistics.

RESULTS:

Of 88 patients, 76 (86%) had a clinical diagnosis of ischemic stroke on discharge and 42 patients (48%) showed a posterior circulation infarct on follow-up imaging. Model C (area under the curve from the receiver operating characteristic curve=0.86; 95% confidence interval, 0.77-0.94) predicted an infarct in the posterior circulation territory better than models A (area under the curve from the receiver operating characteristic curve=0.64; 95% confidence interval, 0.53-0.76; P(C versus A)<0.001) and B (area under the curve from the receiver operating characteristic curve=0.68; 95% confidence interval, 0.56-0.79; P(C versus B)<0.001).

CONCLUSIONS:

CT perfusion has significant additional diagnostic values to noncontrast CT and CT angiography source images for detecting ischemic changes in patients suspected of acute posterior circulation stroke.
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Texto completo: 1 Base de dados: MEDLINE Medicinas Complementares: Homeopatia Assunto principal: Tomografia Computadorizada por Raios X / Isquemia Encefálica / Circulação Cerebrovascular / Acidente Vascular Cerebral / Modelos Neurológicos Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Stroke Ano de publicação: 2015 Tipo de documento: Article
Texto completo
Adicionar na Minha BVS
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XML
PubMed Links
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Texto completo: 1 Base de dados: MEDLINE Medicinas Complementares: Homeopatia Assunto principal: Tomografia Computadorizada por Raios X / Isquemia Encefálica / Circulação Cerebrovascular / Acidente Vascular Cerebral / Modelos Neurológicos Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Stroke Ano de publicação: 2015 Tipo de documento: Article