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<meta name="DC.Title" content="Measuring Elevated Microvascular Permeability and Predicting Hemorrhagic Transformation in Acute Ischemic Stroke Using First-Pass Dynamic Perfusion CT Imaging" />
<meta name="DC.Identifier" content="10.3174/ajnr.A0539" />
<meta name="DC.Date" content="2007-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Hemorrhagic transformation (HT) can be a devastating complication of acute ischemic stroke (AIS). The purpose of this study was to determine whether increased microvascular permeability (PS) of the blood-brain barrier was detected in early AIS by using first-pass dynamic perfusion CT (PCT) and whether PS was significantly higher in infarcts destined for HT.

MATERIALS AND METHODS: Fifty patients with AIS less than 3 hours old and evaluated by PCT were included. PS color maps were retrospectively generated from PCT data using the Patlak model. One reader analyzed each PS map by drawing 4 circular 10-mm regions of interest on any focal abnormality. The mean of these 4 regions of interest represented the PS of the infarct (PSinfarct). The mean of 4 mirror regions of interest on the nonischemic contralateral hemisphere was also obtained (PScontrol). PSinfarct and PScontrol were compared by using an exact Wilcoxon test. PSinfarct for infarcts that developed HT on follow-up (PSHT) was compared with all of the others (PSNo-HT) using an exact Mann-Whitney test.

RESULTS: Forty-four infarcts (88%) showed focal PS elevation in the region of infarct. In units of milliliters per 100 milliliters per minute, PSinfarct ranged from 0 to 13 (mean: 3.5 ± 3.1) versus PScontrol of 0–0.8 (mean: 0.28 ± 0.27; P &lt; .0001). Six infarcts (12%) developed HT, all of which were within the region of PS elevation. PSHT ranged from 5.2 to 13 (mean: 9.8 ± 2.9) versus PSNo-HT of 0–5.9 (mean: 2.7 ± 2.0; P &lt; .0001). Eighteen infarcts (36%) were treated with recombinant tissue plasminogen activator (rtPA). A significant difference between PSHT and PSNo-HT persisted irrespective of rtPA treatment.

CONCLUSIONS: Elevated permeability was detectable in AIS by using first-pass PCT and it predicted subsequent HT." />
<meta name="DC.Contributor" content="K. Lin" />
<meta name="DC.Contributor" content="K.S. Kazmi" />
<meta name="DC.Contributor" content="M. Law" />
<meta name="DC.Contributor" content="J. Babb" />
<meta name="DC.Contributor" content="N. Peccerelli" />
<meta name="DC.Contributor" content="B.K. Pramanik" />
<meta name="article:published_time" content="2007-08-01" />
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<meta name="citation_title" content="Measuring Elevated Microvascular Permeability and Predicting Hemorrhagic Transformation in Acute Ischemic Stroke Using First-Pass Dynamic Perfusion CT Imaging" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;b&gt;BACKGROUND AND PURPOSE:&lt;/b&gt; Hemorrhagic transformation (HT) can be a devastating complication of acute ischemic stroke (AIS). The purpose of this study was to determine whether increased microvascular permeability (PS) of the blood-brain barrier was detected in early AIS by using first-pass dynamic perfusion CT (PCT) and whether PS was significantly higher in infarcts destined for HT.&lt;/p&gt;&lt;p&gt;&lt;b&gt;MATERIALS AND METHODS:&lt;/b&gt; Fifty patients with AIS less than 3 hours old and evaluated by PCT were included. PS color maps were retrospectively generated from PCT data using the Patlak model. One reader analyzed each PS map by drawing 4 circular 10-mm regions of interest on any focal abnormality. The mean of these 4 regions of interest represented the PS of the infarct (PS&lt;sub&gt;infarct&lt;/sub&gt;). The mean of 4 mirror regions of interest on the nonischemic contralateral hemisphere was also obtained (PS&lt;sub&gt;control&lt;/sub&gt;). PS&lt;sub&gt;infarct&lt;/sub&gt; and PS&lt;sub&gt;control&lt;/sub&gt; were compared by using an exact Wilcoxon test. PS&lt;sub&gt;infarct&lt;/sub&gt; for infarcts that developed HT on follow-up (PS&lt;sub&gt;HT&lt;/sub&gt;) was compared with all of the others (PS&lt;sub&gt;No-HT&lt;/sub&gt;) using an exact Mann-Whitney test.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS:&lt;/b&gt; Forty-four infarcts (88%) showed focal PS elevation in the region of infarct. In units of milliliters per 100 milliliters per minute, PS&lt;sub&gt;infarct&lt;/sub&gt; ranged from 0 to 13 (mean: 3.5 ± 3.1) versus PS&lt;sub&gt;control&lt;/sub&gt; of 0–0.8 (mean: 0.28 ± 0.27; &lt;i&gt;P&lt;/i&gt; &amp;lt; .0001). Six infarcts (12%) developed HT, all of which were within the region of PS elevation. PS&lt;sub&gt;HT&lt;/sub&gt; ranged from 5.2 to 13 (mean: 9.8 ± 2.9) versus PS&lt;sub&gt;No-HT&lt;/sub&gt; of 0–5.9 (mean: 2.7 ± 2.0; &lt;i&gt;P&lt;/i&gt; &amp;lt; .0001). Eighteen infarcts (36%) were treated with recombinant tissue plasminogen activator (rtPA). A significant difference between PS&lt;sub&gt;HT&lt;/sub&gt; and PS&lt;sub&gt;No-HT&lt;/sub&gt; persisted irrespective of rtPA treatment.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSIONS:&lt;/b&gt; Elevated permeability was detectable in AIS by using first-pass PCT and it predicted subsequent HT.&lt;/p&gt;" />
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<meta name="twitter:title" content="Measuring Elevated Microvascular Permeability and Predicting Hemorrhagic Transformation in Acute Ischemic Stroke Using First-Pass Dynamic Perfusion CT Imaging" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Hemorrhagic transformation (HT) can be a devastating complication of acute ischemic stroke (AIS). The purpose of this study was to determine whether increased microvascular permeability (PS) of the blood-brain barrier was detected in early AIS by using first-pass dynamic perfusion CT (PCT) and whether PS was significantly higher in infarcts destined for HT.

MATERIALS AND METHODS: Fifty patients with AIS less than 3 hours old and evaluated by PCT were included. PS color maps were retrospectively generated from PCT data using the Patlak model. One reader analyzed each PS map by drawing 4 circular 10-mm regions of interest on any focal abnormality. The mean of these 4 regions of interest represented the PS of the infarct (PSinfarct). The mean of 4 mirror regions of interest on the nonischemic contralateral hemisphere was also obtained (PScontrol). PSinfarct and PScontrol were compared by using an exact Wilcoxon test. PSinfarct for infarcts that developed HT on follow-up (PSHT) was compared with all of the others (PSNo-HT) using an exact Mann-Whitney test.

RESULTS: Forty-four infarcts (88%) showed focal PS elevation in the region of infarct. In units of milliliters per 100 milliliters per minute, PSinfarct ranged from 0 to 13 (mean: 3.5 ± 3.1) versus PScontrol of 0–0.8 (mean: 0.28 ± 0.27; P &lt; .0001). Six infarcts (12%) developed HT, all of which were within the region of PS elevation. PSHT ranged from 5.2 to 13 (mean: 9.8 ± 2.9) versus PSNo-HT of 0–5.9 (mean: 2.7 ± 2.0; P &lt; .0001). Eighteen infarcts (36%) were treated with recombinant tissue plasminogen activator (rtPA). A significant difference between PSHT and PSNo-HT persisted irrespective of rtPA treatment.

CONCLUSIONS: Elevated permeability was detectable in AIS by using first-pass PCT and it predicted subsequent HT." />
<meta name="og-title" property="og:title" content="Measuring Elevated Microvascular Permeability and Predicting Hemorrhagic Transformation in Acute Ischemic Stroke Using First-Pass Dynamic Perfusion CT Imaging" />
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<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Hemorrhagic transformation (HT) can be a devastating complication of acute ischemic stroke (AIS). The purpose of this study was to determine whether increased microvascular permeability (PS) of the blood-brain barrier was detected in early AIS by using first-pass dynamic perfusion CT (PCT) and whether PS was significantly higher in infarcts destined for HT.

MATERIALS AND METHODS: Fifty patients with AIS less than 3 hours old and evaluated by PCT were included. PS color maps were retrospectively generated from PCT data using the Patlak model. One reader analyzed each PS map by drawing 4 circular 10-mm regions of interest on any focal abnormality. The mean of these 4 regions of interest represented the PS of the infarct (PSinfarct). The mean of 4 mirror regions of interest on the nonischemic contralateral hemisphere was also obtained (PScontrol). PSinfarct and PScontrol were compared by using an exact Wilcoxon test. PSinfarct for infarcts that developed HT on follow-up (PSHT) was compared with all of the others (PSNo-HT) using an exact Mann-Whitney test.

RESULTS: Forty-four infarcts (88%) showed focal PS elevation in the region of infarct. In units of milliliters per 100 milliliters per minute, PSinfarct ranged from 0 to 13 (mean: 3.5 ± 3.1) versus PScontrol of 0–0.8 (mean: 0.28 ± 0.27; P &lt; .0001). Six infarcts (12%) developed HT, all of which were within the region of PS elevation. PSHT ranged from 5.2 to 13 (mean: 9.8 ± 2.9) versus PSNo-HT of 0–5.9 (mean: 2.7 ± 2.0; P &lt; .0001). Eighteen infarcts (36%) were treated with recombinant tissue plasminogen activator (rtPA). A significant difference between PSHT and PSNo-HT persisted irrespective of rtPA treatment.

CONCLUSIONS: Elevated permeability was detectable in AIS by using first-pass PCT and it predicted subsequent HT." />
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      <h1 class="highwire-cite-title" id="page-title">Measuring Elevated Microvascular Permeability and Predicting Hemorrhagic Transformation in Acute Ischemic Stroke Using First-Pass Dynamic Perfusion CT Imaging</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">K. Lin</span>, <span class="highwire-citation-author" data-delta="1">K.S. Kazmi</span>, <span class="highwire-citation-author" data-delta="2">M. Law</span>, <span class="highwire-citation-author" data-delta="3">J. Babb</span>, <span class="highwire-citation-author" data-delta="4">N. Peccerelli</span> and <span class="highwire-citation-author" data-delta="5">B.K. Pramanik</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2007,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">28 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1292-1298; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A0539 </span></div>
  
  
  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 28</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 7 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">August 2007 </div></div>
      
      
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      <div class="highwire-cite-title">Measuring Elevated Microvascular Permeability and Predicting Hemorrhagic Transformation in Acute Ischemic Stroke Using First-Pass Dynamic Perfusion CT Imaging</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2007, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">28 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1292-1298; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A0539 </span></div>
  
  
  
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