This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Toriyama, T. Articles by Kobayashi, S. Search for Related Content PubMed PubMed Citation Articles by Toriyama, T. Articles by Kobayashi, S.

Stroke, Vol 24, 1933-1944, Copyright © 1993 by American Heart Association

ARTICLES

Functional image of dynamic computed tomography in diagnostic and prognostic evaluation of ischemic stroke within the first 6 hours

T Toriyama, Y Tanizaki, K Hongo, M Osawa and S Kobayashi
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.

BACKGROUND AND PURPOSE: It is important to make a diagnosis before a low-density area appears on computed tomography for appropriate management of acute ischemic stroke. We report the diagnostic and prognostic usefulness of functional image of dynamic computed tomography for acute ischemic stroke. METHODS: Forty-seven patients with ischemic strokes within 6 hours of ictus underwent dynamic computed tomography in which functional images were obtained. These findings were compared with angiographic findings, follow-up computed tomography, and clinical outcome. RESULTS: The functional images were categorized into three groups: (1) cortical type: abnormalities on time to peak image and/or corrected mean transit time image involving mainly cortical structures (29 cases); (2) noncortical type: abnormalities on either or both images limited to noncortical structures (7 cases); and (3) normal type: no abnormalities on both images (11 cases). Cortical type as a diagnostic test for arterial trunk occlusion had a good sensitivity (100%), specificity (95%), and accuracy (98%). Infarction volume on follow-up computed tomography correlated with extension of prolonged time-to-peak area (r = .80, P < .01) and that of prolonged corrected mean transit time area (r = .81, P < .01). Cortical type was associated with significantly unfavorable outcome (P < .01). CONCLUSIONS: Functional image of dynamic computed tomography findings predicted arterial trunk occlusion, infarction volume, and clinical outcome. Therefore, this technique would be useful not only for indicating definitive angiography and subsequent therapy but for evaluating the effectiveness of surgical or medical recanalization.

This article has been cited by other articles:

				H.M. Silvennoinen, L.M. Hamberg, P.J. Lindsberg, L. Valanne, and G.J. Hunter CT Perfusion Identifies Increased Salvage of Tissue in Patients Receiving Intravenous Recombinant Tissue Plasminogen Activator within 3 Hours of Stroke Onset AJNR Am. J. Neuroradiol., June 1, 2008; 29(6): 1118 - 1123. [Abstract] [Full Text] [PDF]

				H. Kassem-Moussa and C. Graffagnino Nonocclusion and Spontaneous Recanalization Rates in Acute Ischemic Stroke: A Review of Cerebral Angiography Studies Arch Neurol, December 1, 2002; 59(12): 1870 - 1873. [Abstract] [Full Text] [PDF]

				J. Rother, L. Jonetz-Mentzel, A. Fiala, J. R. Reichenbach, M. Herzau, W. A. Kaiser, and C. Weiller Hemodynamic Assessment of Acute Stroke Using Dynamic Single-Slice Computed Tomographic Perfusion Imaging Arch Neurol, August 1, 2000; 57(8): 1161 - 1166. [Abstract] [Full Text] [PDF]

				J. P. Muizelaar, P. P. Fatouros, and M. L. Schroder A New Method for Quantitative Regional Cerebral Blood Volume Measurements Using Computed Tomography Stroke, October 1, 1997; 28(10): 1998 - 2005. [Abstract] [Full Text]