CT perfusion derived relative cerebral blood volume < 42 % is negatively associated with poor functional outcomes at discharge in anterior circulation large vessel occlusion stroke

J Clin Neurosci. 2024 Dec:130:110907. doi: 10.1016/j.jocn.2024.110907. Epub 2024 Nov 13.

Abstract

Background and aim: Recent studies have shown that the CT Perfusion (CTP) parameter of rCBV < 42 % lesion volume can predict 90-day functional outcomes in stroke patients. However, its correlation with discharge outcomes, including functional dependence, has not been investigated. Our study aims to evaluate the relationship between rCBV < 42 % and poor functional outcomes at discharge, defined as a modified Rankin score (mRS) of 3 or higher.

Materials and methods: This retrospective study analyzed patients with confirmed occlusion on CT angiography, who also received CT perfusion between 9/1/2017 and 10/01/2023. Statistical tests (Student's T, Mann-Whitney U, and Chi-Square) were used to assess differences. Univariable and multivariable logistic regression analyses were performed to evaluate the associations of rCBV < 42 % with discharge mRS. A p-value ≤ 0.05 was considered significant.

Results: A total of 268 patients [median age: 68 years (IQR: 59-77), 56.3 % female] met the inclusion criteria. Among them, 85 patients (31.7 %) received intravenous thrombolysis (IVT), and 221 patients (82.5 %) underwent mechanical thrombectomy (MT). After adjusting for various variables, logistic regression analysis indicated that rCBV < 42 % lesion volume was associated with poor functional outcomes at discharge (aOR = 0.97, p < 0.05). T.

Conclusion: The rCBV < 42 % could be a valuable tool in prognosticating AIS-LVO patients.

Keywords: Infarct volume; Relative cerebral blood volume; rCBV <42%.

MeSH terms

  • Aged
  • Cerebral Angiography / methods
  • Cerebral Blood Volume* / physiology
  • Cerebrovascular Circulation / physiology
  • Computed Tomography Angiography
  • Female
  • Humans
  • Ischemic Stroke / diagnostic imaging
  • Ischemic Stroke / therapy
  • Male
  • Middle Aged
  • Patient Discharge
  • Retrospective Studies
  • Stroke / diagnostic imaging
  • Stroke / physiopathology
  • Stroke / therapy
  • Tomography, X-Ray Computed
  • Treatment Outcome