Simplified Assessment of Lesion Water Uptake for Identification of Patients within 4.5 Hours of Stroke Onset: An Analysis of the MissPerfeCT Study

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Peter B Sporns - , Universitätsspital Basel (Autor:in)
  • Marco Höhne - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Lennart Meyer - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Christos Krogias - , Ruhr-Universität Bochum (Autor:in)
  • Volker Puetz - , Klinik und Poliklinik für Neurologie, Dresdner NeurovaskuläresCentrum, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Kolja M Thierfelder - , Universitätsmedizin Rostock (Autor:in)
  • Marco Duering - , Universität Basel (Autor:in)
  • Daniel Kaiser - , Institut und Poliklinik für Diagnostische und Interventionelle Neuroradiologie, Dresdner NeurovaskuläresCentrum, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Sönke Langner - , Universitätsmedizin Rostock (Autor:in)
  • Alex Brehm - , Universitätsspital Basel (Autor:in)
  • Lukas T Rotkopf - , Deutsches Krebsforschungszentrum (DKFZ) (Autor:in)
  • Wolfgang G Kunz - , University Hospital Olomouc (Autor:in)
  • Jens Fiehler - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • Walter Heindel - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Peter Schramm - , Universitätsklinikum Schleswig-Holstein Campus Lübeck (Autor:in)
  • Heinz Wiendl - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Heike Minnerup - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Marios Nikos Psychogios - , Universitätsspital Basel (Autor:in)
  • André Kemmling - , Universitätsklinikum Gießen und Marburg GmbH (Autor:in)
  • Jens Minnerup - , Westfälische Wilhelms-Universität Münster (Autor:in)

Abstract

BACKGROUND AND PURPOSE: Many patients with stroke cannot receive intravenous thrombolysis because the time of symptom onset is unknown. We tested whether a simple method of computed tomography (CT)-based quantification of water uptake in the ischemic tissue can identify patients with stroke onset within 4.5 hours.

METHODS: This retrospective analysis of the MissPerfeCT study (August 2009 to November 2017) includes consecutive patients with known onset of symptoms from seven tertiary stroke centers. We developed a simplified algorithm based on region of interest (ROI) measurements to quantify water uptake of the ischemic lesion and thereby quantify time of symptom onset within and beyond 4.5 hours. Perfusion CT was used to identify ischemic brain tissue, and its density was measured in non-contrast CT and related to the density of the corresponding area of the contralateral hemisphere to quantify lesion water uptake.

RESULTS: Of 263 patients, 204 (77.6%) had CT within 4.5 hours. Water uptake was significantly lower in patients with stroke onset within (6.7%; 95% confidence interval [CI], 6.0% to 7.4%) compared to beyond 4.5 hours (12.7%; 95% CI, 10.7% to 14.7%). The area under the curve for distinguishing these patient groups according to percentage water uptake was 0.744 with an optimal cut-off value of 9.5%. According to this cut-off the positive predictive value was 88.8%, sensitivity was 73.5%, specificity 67.8%, negative predictive value was 42.6%.

CONCLUSIONS: Ischemic stroke patients with unknown time of symptom onset can be identified as being within a timeframe of 4.5 hours using a ROI-based method to assess water uptake on admission non-contrast head CT.

Details

OriginalspracheEnglisch
Seiten (von - bis)390-395
Seitenumfang6
Fachzeitschrift Journal of stroke : JoS
Jahrgang24
Ausgabenummer3
PublikationsstatusVeröffentlicht - Sept. 2022
Peer-Review-StatusJa

Externe IDs

ORCID /0000-0001-5258-0025/work/146644930
PubMed 36221942
PubMedCentral PMC9561216

Schlagworte

Schlagwörter

  • Brain ischemia, Ischemic stroke, Stroke

Bibliotheksschlagworte