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|Title:||Computed tomography perfusion as a diagnostic tool for seizures after ischemic stroke.|
|Authors:||Koome, Miriam;Churilov, Leonid;Chen, Ziyuan;Chen, Ziyi;Naylor, Jillian;Thevathasan, Arthur;Yan, Bernard;Kwan, Patrick|
|Affiliation:||Melbourne Brain Centre, The Royal Melbourne Hospital, Parkville, VIC, 3050, Australia..|
Florey Neuroscience Institutes, Austin Health, University of Melbourne, Heidelberg, Victoria, Australia
School of Medicine, Tsinghua University, Beijing, China
First Affiliated Hospital, Sun Yat-Sen University, Guangdong, China
Department of Medicine, The University of Melbourne, Melbourne, Australia
|Citation:||Neuroradiology 2016; 58(6): 577-584|
|Abstract:||Cerebral cortical ischemia is a risk factor for post-stroke seizures. However, the optimal imaging method is unclear. We investigated CT perfusion (CTP) in detecting cortical ischemia and its correlation with post-stroke seizures compared with non-contrast CT (NCCT). We included patients with acute ischemic stroke admitted to the Royal Melbourne Hospital between 2009 and 2014. Post-stroke seizure information was collected. Cortical involvement was determined on acute NCCT and CTP (T max, cerebral blood volume [CBV], and cerebral blood flow [CBF]). The association between cortical involvement detected by different imaging modalities and post-stroke seizures was examined. Three-hundred fifty-two patients were included for analysis. Fifty-nine percent were male, and median age was 73 years (inter-quartile range 61-82). Follow-up was available for 96 %; median follow-up duration was 377 days (inter-quartile range 91-1018 days). Thirteen patients had post-stroke seizures (3.9 %). Cortical involvement was significantly associated with post-stroke seizures across all modalities. CBV had the highest hazard ratio (11.3, 95 % confidence interval (CI) 1.1-41.2), followed by NCCT (5.3, 95 % CI 1.5-18.0) and CBF (4.2, 95 % CI 1.1-15.2). Sensitivity was highest for T max (100 %), followed by CBV and CBF (both 76.9 %) and NCCT (63.6 %). Specificity was highest for CBV (77.8 %), then NCCT (75.6 %), CBF (54.0 %), and T max (29.1 %). Receiver-operating characteristic area under the curve was significantly different between imaging modalities (p < 0.001), CBV 0.77, NCCT 0.70, CBF 0.65, and T max 0.65. CTP may improve sensitivity and specificity of cortical involvement for post-stroke seizures compared to NCCT.|
|Appears in Collections:||Journal articles|
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