Prediction intra- infarct hemorrhage by blood brain barrier indice on perfusion CT scanner in acute ischemic stroke patient

Nguyen Truong Giang1,2, Alan Coulthard3,4, Andrew Wong5, Nabeel Sheikh6, Robert Henderson6, John D. O’sullivan6, David Reutens5,7,
1 Center for Advanced Medical Imaging, University Queensland, Australia
2 Department of Radiology, General Hospital Faculty of Central Thai Nguyen
3 Department of Diagnostic Imaging, University of Queensland, Australia
4 Imaging dept, Royal Brisbane Hospital, Queensland, Australia
5 Stroke Unit, Faculty Neurology Hoang Hospital Gia Brisbane, Queensland, Australia
6 Stroke Unit, Department of Neurology, Royal Hospital Gia Brisbane, Queensland, Australia
7 Y . Image Center Advanced Study, University Queensland, Australia

Main Article Content

Abstract

SUMMARY


Background: Haemorrhagic transformation is the leading
cause of early neurological deterioration in patients with acute ischaemic stroke. Early prediction of this complication is important
for selecting appropriate treatment methods, preventing and planning for the complication. Existing predictors of haemorrhagic
transformation remain limitations in prognosis accuracy, clinical
practicality and radiation safety. The aim of this study is assess
the role of blood-brain barrier permeability in prediction of haemorrhagic transformation.
Methods: Blood-brain barrier permeanility was obtained using perfusion CT data with implication of the Gjedde-Patlak plot.
The obtained permeability value was used to predict occurrence
of haemorrhagic transformation.
Results: mean blood-brain barrier permeability in lesions
developed haemorrhagic transformation was found significantly
higher than the value obtained in the lesion without complications.
There were a significant relationship between increased permeability and occurence of haemorrhagic transformation. The
threshold of 2.7ml/100g/min was established, above that stroke
patients are at high risk of having haemorrhagic transfomation.
Conclusion: Increased blood-brain barrier permeability
is onf of the factor related to haemorrhagic transformation
in patients with acute ischaemic stroke. The perfusion CT obtained permeability is proven as a predictor of haemorrhagic transformation. Together with other clinical and imaging findings, pattern of blood-brain barrier permeability is recommended to
be included into initial perfusion CT analysis. This may improve
prediction, prevention and planning for medical nanagement in
patients with acute ischaemic stroke.

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References

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