Background and Purpose: The recent thrombectomy trials have shown that perfusion imaging is helpful in proper patient selection in thromboembolic stroke. In this study, we analyzed the correlation of pretreatment T-max volumes in MR and CT perfusion with clinical outcome after thrombectomy. Methods: Forty-one consecutive patients with middle cerebral artery occlusion (MCA) or carotid T occlusion treated with thrombectomy were included. T-max volumes at delays of >4, 6, 8, and 10s as well as infarct core and mismatch ratio were automatically estimated in preinterventional MRI or CT perfusion using RAPID software. These perfusion parameters were correlated with clinical outcome. Outcome was assessed using modified Rankin scale at 90days. Results: In patients with successful recanalization of MCA occlusion, T-max>8 and 10s showed the best linear correlation with clinical outcome (r=0.75; p=.0139 and r=0.73; p=.0139), better than infarct core (r=0.43; p=.2592). In terminal internal carotid artery occlusions, none of the perfusion parameters showed a significant correlation with clinical outcome. Conclusions: T-max at delays of >8 and 10s is a good predictor for clinical outcome in MCA occlusions. In carotid T occlusion, however, T-max volumes do not correlate with outcome.
Useful keywords (using NLM MeSH Indexing)
Aged, 80 and over
Infarction, Middle Cerebral Artery/diagnostic imaging*
Infarction, Middle Cerebral Artery/pathology
Magnetic Resonance Imaging
Tomography, X-Ray Computed
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