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Comparison of Different Methods of Thrombus Permeability Measurement and Impact on Recanalization in the INTERRSeCT Multinational Multicenter Prospective Cohort Study

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Author(s)
Henrik GensickeJames W EvansFahad S. Al AjlanDar DowlatshahiMohamed NajmAna L. CallejaJosep PuigSung-lI SohnSeong H. AhnAlexandre Y. PoppeRobert MikulikNegar AsdaghiThalia S. FieldAlbert JinTalip AsilJean-Martin BoulangerMichael D. HillMayank GoyalAndrew M. DemchukBijoy K. Menon
Keimyung Author(s)
Sohn, Sung Il
Department
Dept. of Neurology (신경과학)
Journal Title
Neuroradiology
Issued Date
2019
Keyword
Acute ischemic strokeThrombus permeabilityRecanalization therapiesNCCTCTA
Abstract
Purpose:
To compare the association of different measures of intracranial thrombus permeability on non-contrast computerized tomography (NCCT) and computed tomography angiography (CTA) with recanalization with or without intravenous alteplase.

Methods:
Patients with anterior circulation occlusion from the INTERRSeCT study were included. Thrombus permeability was measured on non-contrast CT and CTA using the following methods: [1] automated method, mean attenuation increase on co-registered thin (< 2.5 mm) CTA/NCCT; [2] semi-automated method, maximum attenuation increase on non-registered CTA/NCCT (ΔHUmax); [3] manual method, maximum attenuation on CTA (HUmax); and [4] visual method, residual flow grade. Primary outcome was recanalization with intravenous alteplase on the revised AOL scale (2b/3). Regression models were compared using C-statistic, Akaike (AIC), and Bayesian information criterion (BIC).

Results:
Four hundred eighty patients were included in this analysis. Statistical models using methods 2, 3, and 4 were similar in their ability to discriminate recanalizers from non-recanalizers (C-statistic 0.667, 0.683, and 0.634, respectively); method 3 had the least information loss (AIC = 483.8; BIC = 492.2). A HUmax ≥ 89 measured with method 3 provided optimal sensitivity and specificity in discriminating recanalizers from non-recanalizers [recanalization 55.4% (95%CI 46.2–64.6) when HUmax > 89 vs. 16.8% (95%CI 13.0–20.6) when HUmax ≤ 89]. In sensitivity analyses restricted to patients with co-registered CTA/NCCT (n = 88), methods 1–4 predicted recanalization similarly (C-statistic 0.641, 0.688, 0.640, 0.648, respectively) with Method 2 having the least information loss (AIC 104.8, BIC 109.8).

Conclusion:
Simple methods that measure thrombus permeability are as reliable as complex image processing methods in discriminating recanalizers from non-recanalizers.
Keimyung Author(s)(Kor)
손성일
Publisher
School of Medicine (의과대학)
Citation
Henrik Gensicke et al. (2019). Comparison of Different Methods of Thrombus Permeability Measurement and Impact on Recanalization in the INTERRSeCT Multinational Multicenter Prospective Cohort Study. Neuroradiology. doi: 10.1007/s00234-019-02320-y
Type
Article
ISSN
1432-1920
Source
https://link.springer.com/article/10.1007%2Fs00234-019-02320-y
DOI
10.1007/s00234-019-02320-y
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42400
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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