Dokument: Diagnostic Value of Perfusion Parameters for Differentiation of Underlying Etiology in Internal Carotid Artery Occlusions

Titel:Diagnostic Value of Perfusion Parameters for Differentiation of Underlying Etiology in Internal Carotid Artery Occlusions
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=68863
URN (NBN):urn:nbn:de:hbz:061-20250228-102231-0
Kollektion:Publikationen
Sprache:Englisch
Dokumententyp:Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:Text
Autoren: Weiss, Daniel [Autor]
Lang, Henrik [Autor]
Rubbert, Christian [Autor]
Jannusch, Kai [Autor]
Kaschner, Marius [Autor]
Ivan, Vivien Lorena [Autor]
Caspers, Julian [Autor]
Turowski, Bernd [Autor]
Jansen, Robin [Autor]
Lee, John-Ih [Autor]
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Dateien vom 28.02.2025 / geändert 28.02.2025
Stichwörter:Dissection, Stroke, Embolic, Macroangiopathy, Endovascular treatment
Beschreibung:Purpose

Occlusions of the internal carotid artery (ICA) may be caused by dissection, embolic or macroangiopathic pathogenesis, which partially influences the treatment; however, inferring the underlying etiology in computed tomography angiography can be challenging. In this study, we investigated whether computed tomography perfusion (CT-P) parameters could be used to distinguish between etiologies.
Methods

Patients who received CT‑P in acute ischemic stroke due to ICA occlusion between 2012 and 2019 were retrospectively analyzed. Group comparisons between etiologies regarding the ratios of CT‑P parameters between both hemispheres for relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), time to maximum (Tmax), and mean transit time (MTT) were calculated by one-factorial analysis of variance (ANOVA) and compared by pairwise Bonferroni post hoc tests. An receiver operating characteristics (ROC) analysis was performed if differences in group comparisons were found. Multinomial logistic regression (MLR) including pretherapeutic parameters was calculated for etiologies.
Results

In this study 69 patients (age = 70 ± 14 years, dissection = 10, 14.5%, embolic = 19, 27.5% and macroangiopathic = 40, 58.0%) were included. Group differences in ANOVA were only found for MTT ratio (p = 0.003, η2 = 0.164). In the post hoc test, MTT ratio showed a differentiability between embolic and macroangiopathic occlusions (p = 0.002). ROC analysis for differentiating embolic and macroangiopathic ICA occlusions based on MTT ratio showed an AUC of 0.77 (p < 0.001, CI = 0.65–0.89) and a cut-off was yielded at a value of 1.15 for the MTT ratio (sensitivity 73%, specificity 68%). The MLR showed an overall good model performance.
Conclusion

It was possible to differentiate between patients with embolic and macroangiopathic ICA occlusions based on MTT ratios and to define a corresponding cut-off. Differentiation from patients with dissection versus the other etiologies was not possible by CT‑P parameters in our sample.
Rechtliche Vermerke:Originalveröffentlichung:
Weiß, D. A., Lang, H., Rubbert, C., Jannusch, K., Kaschner, M., Ivan, V. L., Caspers, J., Turowski, B., Jansen, R., Lee, J.-I., Ruck, T., Meuth, S., & Gliem, M. (2023). Diagnostic Value of Perfusion Parameters for Differentiation of Underlying Etiology in Internal Carotid Artery Occlusions. Clinical Neuroradiology, 34, 219–227. https://doi.org/10.1007/s00062-023-01349-0
Lizenz:Creative Commons Lizenzvertrag
Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:28.02.2025
Dateien geändert am:28.02.2025
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