Image features and role of 128-slice ct perfusion in diagnosis of acute ischemic stroke due to internal carotid artery occlusion

Sor Sotheary1,, Vu Dang Luu2, Tran Anh Tuan3, Nguyen Quang Anh3, Nguyen Tat Thien4
1 Bach Mai hospital
2 Bach Mai Hospital
3 Bạch Mai hospital
4 Bach mai hospital

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Abstract

Abstract: For acute ischemic stroke (AIS) patient, assessment of cerebral injury plays a very important role in choosing treatment for better outcome and reduces mortality. CT perfusion (CTP) can assess the infarct area and tissue at risk area. Therefore, CTP has a very important role in the choice of treatment and prognosis for AIS patient.
Objective: (1) Image features of 128-slice CT perfusion in diagnosis of ASI. (2) Role of CTP in assessing the extent and prognosis of acute cerebral infarction due to internal carotid artery occlusion.
Method: A prospective descriptive cross-sectional study of 35 acute ischemic stroke due to internal carotid artery occlusion patients, had 128-slice CT perfusion, and indicated for mechanical thrombectomy in Bach Mai Radiology Center from April 2019 to June 2020.
Results: Mean age of 66.57 ± 11.98, the average baseline NIHSS was 17.23 ± 4.47, 32 patients (91.43%) had early infarcted signs on Noncontrast CT (NCCT). ICA occlusion site: ICA 20%, Tandem 42.9%, ICA Terminus 37.1%. Mean volume of infarct core 34.60 ± 33.34 cm3, and penumbra 102.98 ± 40.07 cm3. Mean relative MTT 252.86 ± 81.49%. Mean CBV infarct core 1.19 ± 0.39 ml / 100g. ASPECTS score and infarct core volume, as well as the rate of post-intervention bleeding with infarct core volume were statistically significant (p <0.05).
Conclusion: A 128-slicce CTP of AIS due to ICA occlusion is characterized by: mean infarct core volume is greater than mean infarct core volume of AIS due to anterior circulation large artery occlusion (AC-LAO) in general, although the majority of patients were admitted to the hospital early. From the correlation between infarct core volume and the risk of post-intervention bleeding, it is possible to predict patients with AIS due to ICA have higher rate of post-intervention bleeding than patients with AIS due to AC-LAO in general.

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References

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