scholarly journals Predictive Value of CT Perfusion Imaging on the Basis of Automatic Segmentation Algorithm to Evaluate the Collateral Blood Flow Status on the Outcome of Reperfusion Therapy for Ischemic Stroke

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Qingsong Gong ◽  
Botao Yu ◽  
Mengjie Wang ◽  
Min Chen ◽  
Haowen Xu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Perfusion Imaging ◽  
Ct Perfusion ◽  
Automatic Segmentation ◽  
Reperfusion Therapy ◽  
Segmentation Algorithm ◽  
Collateral Flow ◽  
Collateral Blood Flow ◽  
Ct Perfusion Imaging

Our objective was to study the predictive value of CT perfusion imaging based on automatic segmentation algorithm for evaluating collateral blood flow status in the outcome of reperfusion therapy for ischemic stroke. All data of 30 patients with ischemic stroke reperfusion in our hospital were collected and examined by CT perfusion imaging. Convolutional neural network (CNN) algorithm was used to segment perfusion imaging map and evaluate the results. The patients were grouped by regional leptomeningeal collateral score (rLMCs). Binary logistic regression was used to analyze the independent influencing factors of collateral blood flow on brain CT perfusion. The modified Scandinavian Stroke Scale was used to evaluate the prognosis of patients, and the effects of different collateral flow conditions on prognosis were obtained. The accuracy of CNN segmentation image is 62.61%, the sensitivity is 87.42%, the similarity coefficient is 93.76%, and the segmentation result quality is higher. Blood glucose (95% CI = 0.943, P = 0.028 ) and ischemic stroke history (95% CI = 0.855, P = 0.003 ) were independent factors affecting the collateral blood flow status of stroke patients. CBF (95% CI = 0.818, P = 0.008 ) and CBV (95% CI = 0.796, P = 0.016 ) were independent influencing factors of CT perfusion parameters. After 3 weeks of onset, the prognostic function defect score of the good collateral flow group (11.11%) was lower than that of the poor group (41.67%) ( P < 0.05 ). The automatic segmentation algorithm has more accurate segmentation ability for stroke CT perfusion imaging and plays a good auxiliary role in the diagnosis of clinical stroke reperfusion therapy. The collateral blood flow state based on CT perfusion imaging is helpful to predict the treatment outcome of patients with ischemic stroke and further predict the prognosis of patients.

Abstract T P41: Determination of Collateral Supply Patterns Using MR or CT Perfusion Imaging

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Cihat Eldeniz ◽  
Yueh Lee ◽  
Maria Gisele Matheus ◽  
Jeffery Keith Smith ◽  
James Faber ◽  
...  
Keyword(s):  
Perfusion Imaging ◽  
Ct Perfusion ◽  
Mapping Method ◽  
Collateral Flow ◽  
Scoring Method ◽  
Flow Mapping ◽  
Flow Maps ◽  
Ct Perfusion Imaging ◽  
Ischemic Tissue ◽  
Flow Information

Introduction: In this study, we sought to develop a collateral flow mapping method based on MR or CT perfusion imaging and compare this method with the digital subtraction angiography (DSA) method. Methods: Ischemic tissue supplied by collateral flow is likely to have delayed tracer arrival but relatively normal flow. In this study, abnormal Tmax (> 6 sec), MTT (4 sec or greater than unaffected hemisphere) and CBF (<40% of unaffected hemisphere) were labeled with green, red and blue, respectively (Fig. A). Any perfusion patterns can then be represented by a combination of this integrated RGB maps (Integrated Collateral flow Maps, iCMaps). 24 patients were included in this study. DSA images were obtained from all patients, whereas MR and CT perfusion images were acquired from 15 and 9 patients, respectively, within 30 hours after MCA occlusion. iCMaps collateral flow was scored independently as follows. iCMaps without any perfusion abnormality was assigned “1”. iCMaps with white as the dominant perfusion pattern was assigned a “5”; while those with a dominant green and yellow pattern were assigned a “2” or a “3”, depending on the relative green and yellow volume. Finally, iCMaps with a white region surrounded with yellow and green was assigned a “4”. Examples of iCMaps scoring are shown in Fig. B. Using a DSA scoring method in the literature5, a score of 1-5 was given independently based on the degree of retrograde collateralization (5: poor collateralization). Results: Good correlation was found between the MR perfusion iCMaps and DSA (DSA=0.70*MR iCMaps+0.54, R=0.75). Moderate correlation was obtained between the CT perfusion iCMaps and DSA (DSA=0.51*CT iCMaps+1.9, R=0.56). Conclusions: Based on the different characteristics of Tmax, MTT and CBF maps, the proposed MR or CT perfusion based iCMaps method can provide DSA comparable collateral flow information.

Automated CT perfusion imaging for acute ischemic stroke

Neurology ◽  
2019 ◽  
pp. 10.1212/WNL.0000000000008481 ◽  
Author(s):  
Achala Vagal ◽  
Max Wintermark ◽  
Kambiz Nael ◽  
Andrew Bivard ◽  
Mark Parsons ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Perfusion Imaging ◽  
Ct Perfusion ◽  
Ct Perfusion Imaging

scholarly journals Dynamic CT Perfusion Imaging for the Detection of Crossed Cerebellar Diaschisis in Acute Ischemic Stroke

2012 ◽  
Vol 13 (1) ◽  
pp. 12 ◽  
Author(s):  
Young Wook Jeon ◽  
Seo Hyun Kim ◽  
Ji Yong Lee ◽  
Kum Whang ◽  
Myung Soon Kim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Perfusion Imaging ◽  
Ct Perfusion ◽  
Dynamic Ct ◽  
Crossed Cerebellar Diaschisis ◽  
Ct Perfusion Imaging ◽  
Cerebellar Diaschisis

scholarly journals Augmenting Collateral Blood Flow during Ischemic Stroke via Transient Aortic Occlusion

2013 ◽  
Vol 34 (1) ◽  
pp. 61-71 ◽  
Author(s):  
Ian R Winship ◽  
Glenn A Armitage ◽  
Gomathi Ramakrishnan ◽  
Bin Dong ◽  
Kathryn G Todd ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Collateral Circulation ◽  
Aortic Occlusion ◽  
Collateral Flow ◽  
Collateral Blood Flow ◽  
Flow Through ◽  
Transient Aortic Occlusion

Collateral circulation provides an alternative route for blood flow to reach ischemic tissue during a stroke. Blood flow through the cerebral collaterals is a critical predictor of clinical prognosis after stroke and response to recanalization, but data on collateral dynamics and collateral therapeutics are lacking. Here, we investigate the efficacy of a novel approach to collateral blood flow augmentation to increase collateral circulation by optically recording blood flow in leptomeningeal collaterals in a clinically relevant model of ischemic stroke. Using high-resolution laser speckle contrast imaging (LSCI) during thromboembolic middle cerebral artery occlusion (MCAo), we demonstrate that transiently diverting blood flow from peripheral circulation towards the brain via intra-aortic catheter and balloon induces persistent increases in blood flow through anastomoses between the anterior and middle cerebral arteries. Increased collateral flow restores blood flow in the distal middle cerebral artery segments to baseline levels during aortic occlusion and persists for over 1 hour after removal of the aortic balloon. Given the importance of collateral circulation in predicting stroke outcome and response to treatment, and the potential of collateral flow augmentation as an adjuvant or stand-alone therapy for acute ischemic stroke, this data provide support for further development and translation of collateral therapeutics including transient aortic occlusion.

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