+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Blood-brain barrier permeability assessed by perfusion computed tomography predicts hemorrhagic transformation in acute reperfusion therapy



Blood-brain barrier permeability assessed by perfusion computed tomography predicts hemorrhagic transformation in acute reperfusion therapy



Neurological Sciences 2018



Hemorrhagic transformation (HT) is one of the most feared complications of acute recanalization therapies. The aim of this study was to evaluate whether blood-brain barrier permeability (BBBP) imaging can predict HT in the setting of acute recanalization therapy and to determine the sensitivity and specificity of BBBP for the prediction of HT according to the type of reperfusion therapy. We assessed a total of 46 patients who received recanalization therapy (intravenous (IV) recombinant tissue plasminogen activator (tPA), mechanical thrombectomy with a stent retriever or both) for acute ischemic stroke within the internal carotid artery or middle cerebral artery. BBBP above the threshold was significantly associated with HT after adjustment for confounding factors in all patients (OR 45.4, 95% CI 2.9~711.2, p = 0.007), patients who received IV tPA (OR 20.1, 95% CI 1.2-336.7, p = 0.037), and patients who received endovascular therapy (OR 47.2, 95% CI 1.9-1252.5, p = 0.022). The sensitivity and specificity of the initial BBBP measurement as a predictor of HT in the overall 46 patients were 80 and 71%, respectively. These values were 75 and 64% in only IV tPA group, 100 and 80% in only endovascular group, 77 and 67% in IV tPA with or without endovascular therapy group, and 86 and 76% in endovascular therapy with or without bridging IV tPA therapy group. Increased pretreatment BBBP values were significantly associated with HT after acute recanalization therapy. This correlation with HT was stronger in patients receiving endovascular mechanical thrombectomy than in patients receiving IV rtPA.

(PDF emailed within 0-6 h: $19.90)

Accession: 052197097

Download citation: RISBibTeXText

PMID: 29909558

DOI: 10.1007/s10072-018-3468-1


Related references

Increased blood-brain barrier permeability on perfusion computed tomography predicts hemorrhagic transformation in acute ischemic stroke. European Neurology 72(1-2): 45-53, 2015

Blood-brain barrier permeability assessed by perfusion CT predicts symptomatic hemorrhagic transformation and malignant edema in acute ischemic stroke. Ajnr. American Journal of Neuroradiology 32(1): 41-48, 2011

Computed Tomography Perfusion Derived Blood-Brain Barrier Permeability Does Not Yet Improve Prediction of Hemorrhagic Transformation. Cerebrovascular Diseases 45(1-2): 26-32, 2018

Increased blood-brain barrier permeability in contralateral hemisphere predicts worse outcome in acute ischemic stroke after reperfusion therapy. Journal of Neurointerventional Surgery 10(10): 937-941, 2018

Blood-brain barrier permeability imaging using perfusion computed tomography. Radiology and Oncology 49(2): 107-114, 2015

Blood-brain barrier, reperfusion injury, and hemorrhagic transformation in acute ischemic stroke. Neurology 79(13 Suppl 1): S52-S57, 2012

Permeability Surface of Deep Middle Cerebral Artery Territory on Computed Tomographic Perfusion Predicts Hemorrhagic Transformation After Stroke. Stroke 48(9): 2412-2418, 2017

Contrast-enhanced MR imaging in acute ischemic stroke: T2* measures of blood-brain barrier permeability and their relationship to T1 estimates and hemorrhagic transformation. Ajnr. American Journal of Neuroradiology 31(6): 1015-1022, 2010

Acute effect of electroconvulsive therapy on brain perfusion assessed by Tc99m-hexamethylpropyleneamineoxim and single photon emission computed tomography. Acta Psychiatrica Scandinavica 80(5): 421-426, 1989

Computed Tomography Perfusion Alberta Stroke Program Early Computed Tomography Score Is Associated with Hemorrhagic Transformation after Acute Cardioembolic Stroke. Frontiers in Neurology 8: 591, 2017

Relative recirculation: a fast, model-free surrogate for the measurement of blood-brain barrier permeability and the prediction of hemorrhagic transformation in acute ischemic stroke. Investigative Radiology 44(10): 662-668, 2010

Acute brain perfusion disorders in children assessed by quantitative perfusion computed tomography in the emergency setting. Pediatric Emergency Care 21(3): 149-160, 2005

Melatonin attenuates the postischemic increase in blood-brain barrier permeability and decreases hemorrhagic transformation of tissue-plasminogen activator therapy following ischemic stroke in mice. Journal of Pineal Research 40(3): 242-250, 2006

Initial 'TTP Map-Defect' of Computed Tomography Perfusion as a Predictor of Hemorrhagic Transformation of Acute Ischemic Stroke. Cerebrovascular Diseases Extra 3(1): 14-25, 2013

Detection of early vessel leakiness in acute ischemic stroke using computed tomography perfusion may indicate hemorrhagic transformation. Acta Radiologica 48(3): 341-344, 2007