Clinical applications of perfusion imaging in acute ischemic stroke
This project aims to address the following research questions:
* Evaluation of the role of non-contrast computed tomography (CT) and CT perfusion imaging in prediction of acute infarct volume and prognostication of functional outcome.after acute stroke
Although non-contrast CT (using the Alberta Stroke Program Early CT score, ASPECTS) and CT perfusion both have been used in randomized controlled trials to select patients who are more likely to benefit from endovascular perfusion, comparison of their capability for prediction of acute infarct volume and clinical outcome is largely lacking. In two studies, we aim to investigate whether non-contrast CT and CT perfusion can accurately discriminate between small and large acute infarcts and are associated with functional outcome after endovascular reperfusion treatment.
* Evaluation of sex differences in functional outcome after acute stroke treatment and examine the role of perfusion imaging characteristics
The effect of reperfusion treatment for acute ischemic stroke is not modified by sex. However, in clinical trials on reperfusion treatment, women had better cerebral perfusion characteristics and smaller final infarct volumes. In this study we aim to assess an association between sex and clinical outcome after endovascular treatment for ischemic stroke and examine whether possible differences can be explained by differences in perfusion imaging characteristics.
* Evaluation of discongruence between non-contrast CT and CT perfusion imaging in late-presenting patients
Cerebral perfusion in acute stroke is dynamic. Variability of cerebral perfusion affects prediction of brain tissue fate and may cause underestimation of infarct volume, especially in late presenting patients. Often, established infarction is readily visible on non-contrast CT. In this study we aim to examine the frequency and extent of infarct underestimation in late-presenting patients and discongruence between CT perfusion and non-contrast CT.