Predictive value of flat-panel CT for haemorrhagic transformations in patients with acute stroke treated with thrombectomy.

Details

Serval ID
serval:BIB_03C0F8F4580D
Type
Article: article from journal or magazin.
Collection
Publications
Title
Predictive value of flat-panel CT for haemorrhagic transformations in patients with acute stroke treated with thrombectomy.
Journal
Journal of neurointerventional surgery
Author(s)
Rouchaud A., Pistocchi S., Blanc R., Engrand N., Bartolini B., Piotin M.
ISSN
1759-8486 (Electronic)
ISSN-L
1759-8478
Publication state
Published
Issued date
03/2014
Peer-reviewed
Oui
Volume
6
Number
2
Pages
139-143
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Haemorrhagic transformations are pejorative for patients with acute ischaemic stroke (AIS). We estimated flat-panel CT performances to detect brain parenchymal hyperdense lesions immediately after mechanical thrombectomy directly on the angiography table in patients with AIS, and its ability to predict haemorrhagic transformation. We also evaluated an easy-reading protocol for post-procedure flat-panel CT evaluation by clinicians to enable them to determine the potential risk of haemorrhage.
Two neuroradiologists retrospectively reviewed post-procedural flat-panel CT and 24 h follow-up imaging. We evaluated hyperdense lesions on flat-panel CT to predict the occurrence of haemorrhagic transformation within 24 h detected with conventional imaging.
Of 63 patients, 60.3% presented post-procedural parenchymal hyperdensity and 54.0% had haemorrhagic transformation. Significantly more patients with hyperdense lesions on post-thrombectomy flat-panel CT presented haemorrhagic transformation (84.2% vs 8.0%; p<0.0001). No significant haemorrhagic transformations were detected for patients without parenchymal hyperdensity. Sensitivity and specificity of hyperdense lesions on flat-panel CT for the prediction of haemorrhagic transformation were 94.1% (80.3-99.3%) and 79.3% (60.3-92.0%), respectively. The positive and negative predictive values for the occurrence of haemorrhage were 84.2% (68.8-94.0%) and 92.0% (74.0-99.0%), respectively. For significant parenchymal haemorrhage type 2, sensitivity and negative predictive values were 100%. We observed good homogeneity between the different readers. Hyperdensity on post-procedural flat-panel CT was associated with a tendency for higher risk of death and lower risk of good clinical outcome.
Flat-panel CT appears to be a good tool to detect brain parenchymal hyperdensities after mechanical thrombectomy in patients with AIS and to predict haemorrhagic transformation.

Keywords
Adult, Aged, Aged, 80 and over, Cerebral Hemorrhage/diagnostic imaging, Cerebral Hemorrhage/etiology, Cerebral Hemorrhage/surgery, Female, Follow-Up Studies, Humans, Intraoperative Complications/diagnostic imaging, Intraoperative Complications/etiology, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Retrospective Studies, Single-Blind Method, Stroke/diagnostic imaging, Stroke/surgery, Thrombectomy/adverse effects, Tomography, X-Ray Computed/standards, Treatment Outcome
Pubmed
Create date
03/05/2017 11:44
Last modification date
20/08/2019 12:25
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