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Perfusion computed tomography thresholds defining ischemic penumbra and infarct core: Studies in a rat stroke model

Citation

Mcleod, DD and Parsons, MW and Hood, R and Hiles, B and Allen, J and Mccann, SK and Murtha, L and Calford, MB and Levi, CR and Spratt, NJ, Perfusion computed tomography thresholds defining ischemic penumbra and infarct core: Studies in a rat stroke model, International Journal of Stroke, 10, (4) pp. 553-559. ISSN 1747-4930 (2015) [Refereed Article]

Copyright Statement

Copyright 2013 The Authors

DOI: doi:10.1111/ijs.12147

Abstract

Background: Perfusion computed tomography is becoming more widely used as a clinical imaging tool to predict potentially salvageable tissue (ischemic penumbra) after ischemic stroke and guide reperfusion therapies. Aims: The study aims to determine whether there are important changes in perfusion computed tomography thresholds defining ischemic penumbra and infarct core over time following stroke.

Methods: Permanent middle cerebral artery occlusion was performed in adult outbred Wistar rats (n = 6) and serial perfusion computed tomography scans were taken every 30 mins for 2 h. To define infarction thresholds at 1 h and 2 h post-stroke, separate groups of rats underwent 1 h (n = 6) and 2 h (n = 6) of middle cerebral artery occlusion followed by reperfusion. Infarct volumes were defined by histology at 24 h. Co-registration with perfusion computed tomography maps (cerebral blood flow, cerebral blood volume, and mean transit time) permitted pixel-based analysis of thresholds defining infarction, using receiver operating characteristic curves.

Results: Relative cerebral blood flow was the perfusion computed tomography parameter that most accurately predicted penumbra (area under the curve =񁖢98) and also infarct core (area under the curve =񁖣50). A relative cerebral blood flow threshold of < 75% of mean contralateral cerebral blood flow most accurately predicted penumbral tissue at 05 h (area under the curve =񁖢60), 1 h (area under the curve =񁖢59), 15 h (area under the curve =񁖢36), and 2 h (area under the curve =񁖢64) after stroke onset. A relative cerebral blood flow threshold of < 55% of mean contralateral most accurately predicted infarct core at 1 h (area under the curve =񁖣65) and at 2 h (area under the curve =񁖢89) after middle cerebral artery occlusion.

Conclusions: The data provide perfusion computed tomography defined relative cerebral blood flow thresholds for infarct core and ischemic penumbra within the first two hours after experimental stroke in rats. These thresholds were shown to be stable to define the volume of infarct core and penumbra within this time window.

Item Details

Item Type:Refereed Article
Keywords:infarct core, ischemic penumbra, perfusion computed tomography
Research Division:Medical and Health Sciences
Research Group:Neurosciences
Research Field:Neurology and Neuromuscular Diseases
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Nervous System and Disorders
Author:Calford, MB (Professor Mike Calford)
ID Code:91311
Year Published:2015 (online first 2013)
Web of Science® Times Cited:7
Deposited By:Research Division
Deposited On:2014-05-13
Last Modified:2017-10-03
Downloads:0

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