Abstract Details

Title Predict the Ischemic Volumes of Acute Stroke by Using Visual Assessment on CT Perfusion Source Imaging

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (12:00 PM-1:00 PM)

Poster/Presentation
Number 4-019

Objective

We aimed to establish the association between a visual collateral assessment (relative filling time delay, rFTD) based on CT perfusion source imaging (CTP-SI) with ischemic brain tissue volumes calculated by special software in acute ischemic stroke patients.

Background The rFTD based on CTP-SI, which assessed in the Sylvian fissure represents the abundance of leptomeningeal collateral supply, is simple and not software needed.

Design/Methods Consecutive acute ischemic stroke patients with M1 segment of middle cerebral artery (MCA) +/- terminal ICA occlusions on baseline CT angiography and CTP from Dec 2011 to Jul 2019 within 24h of stroke symptom onset were included. Ischemic brain tissue volumes (including infarct core, penumbra and low perfusion) on CTP was analyzed with MIStar software. Three raters assessed rFTD on baseline CTP-SI by consensus. rFTD was then divided into 4 grades: grade 0, rFTD 0s; grade 1, rFTD 1~4s; grade 2, rFTD 5~8s; grade 3, rFTD≥9s. Kruskal-Wallis test was used to analyze the different median ischemic tissue volumes among rFTD grades.

Results One hundred and thirty-eight patients with acute occlusion of MCA +/- ICA were included in this study. The mean patient age was 67.1±12.4 years with 62.3% (86/138) being male. Significant differences among rFTD grades were seen in volumes of infarct core (grade 0: 33.7ml; 1: 63.4ml; 2: 78.5ml and 3: 122.2ml, p<0.001), penumbra (grade 0: 41.8ml; 1: 69.6ml; 2: 78.8ml and 3: 75.35ml, p=0.034) and low perfusion (grade 0: 35.4ml; 1: 65.6ml; 2: 79.4ml and 3: 105.2ml, p<0.001). rFTD≤4s predicted infarct core volume <70ml with a sensitivity of 0.75 (95%CI: 0.66 - 0.83) and a specificity of 0.63 (95%CI: 0.43 - 0.8).

Conclusions rFTD grades could be a useful utility to evaluated ischemic volumes on CTP-SI in hospitals who have no special software.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
QIANG DONG, PhD (Huashan Hospital Fudan University)	No disclosure on file