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Current Neurovascular Research

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ISSN (Print): 1567-2026
ISSN (Online): 1875-5739

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Research Article

Perfusion Deficits in Different Mechanisms of Two Subtypes of Acute Stroke with Diffusion MRI Confirmation

Author(s): Cuiting Zhu, Wei Qin and Wenli Hu*

Volume 20, Issue 1, 2023

Published on: 20 February, 2023

Page: [35 - 42] Pages: 8

DOI: 10.2174/1567202620666221230141102

Price: $65

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Abstract

Background: Branch atheromatous disease (BAD) and lacunar infract (LI) are the different mechanisms of subtypes of acute stroke. We aimed to investigate perfusion deficits and clinical characteristics of the different mechanisms of two subtypes of acute stroke.

Materials and Methods: Five hundred and ninety-nine CTP examinations were retrospectively reviewed between January and December 2021 in patients with acute stroke symptoms with CTP within 12 hours and MRI within 7 days of symptom onset. Based on diffusion MRI, the patients were assigned to one of two subtypes: BAD and LI. Lesion volumes were measured on NCCT, CTA, CBV, CBF, MTT, and TTP maps by region-of-interest analysis and were confirmed by follow-up MRI.

Results: One hundred thirty-three patients met the inclusion criteria (26.3% female). The BAD group was present in 104 of 133 (78.2%), and the LI group 29 of 133 (21.8%). Based on CT perfusion, 42 of 78 (53.8%) BAD group and 5 of 18 (27.8%) LI group had perfusion deficits in the supratentorial region. BAD had a higher proportion of abnormal perfusion than LI patients, with a significant difference (P < 0.05). The sensitivity of CTP ranged from 21.4% (CBV) to 90.5% (TTP); specificity ranged from 97.2% (TTP) to 100% (CBV, CBF, and MTT) in BAD patients.

Conclusion: CTP has high specificity in identifying BAD. Compromised perfusion deficits are more presented in BAD patients compared with LI. CT perfusion imaging may be useful for determining the clinical significance of perfusion abnormalities in BAD occurrence.

Keywords: CT perfusion, MRI, branch atheromatous disease, lacunar infracts, perfusion deficits, acute stroke.

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