Article Figures & Data
Figures
- Fig 1.
Flow chart of the study cohort.
- Fig 2.
PVHs on MR imaging and noncontrast CT.
- Fig 3.
Boxplot analysis of CTP maps in the asymptomatic hemisphere according to the PVH score on MR imaging in the whole population (N = 236).
- Fig 4.
ICC analysis of the predicted final infarct volume on CTP according to different rCBF cutoffs and the grade of leukoaraiosis assessed by the PVH on follow-up MR imaging and on pretreatment NCCT in the subgroup of patients with complete reperfusion after mechanical thrombectomy (n = 127). Of note, the agreement in patients without leukoaraiosis was excellent for rCBF <30% and rCBF <25% cutoffs and remained good for rCBF <20% and rCBF <15%. In patients with leukoaraiosis, across increasing PVHs, the overall reliability of CTP decreased and more restrictive thresholds (mostly rCBF <25% and rCBF <20%) had better agreement than the commonly used rCBF <30%.
- Fig 5.
Representative cases of patients with acute ischemic stroke treated with mechanical thrombectomy. A, A 38-year-old patient with low-grade leukoaraiosis (PVH 0). B, A 79-year-old patient with high-grade leukoaraiosis (PVH 3). Both patients had a left middle cerebral artery stroke due to M1 occlusion and had complete reperfusion (modified TICI score of 3) after mechanical thrombectomy. The CTP-predicted NVT on CBF was similar to final infarct volume in patient A (NVT = 17.9 mL, FIV = 22.2 mL), while in patient B, CTP-predicted NVT overestimated the FIV (NVT = 11.2 mL, FIV = 0.8 mL).
Tables
- Table 1:
General clinical and radiologic characteristics of the whole population and in patients with complete reperfusion
Whole Cohort (n = 236) mTICI 3 Subgroup (n = 127) Age (mean) (SD) (yr) 68.7 (14.6) 68.8 (14.2) Female sex (No.) (%) 116 (49.2) 62 (49.2) Baseline NIHSS score (median) (IQR) 11 (17–21) 16 (9–20) Hypertension (No.) (%) 132 (55.9) 68 (53.5) Diabetes mellitus (No.) (%) 34 (14.4) 21 (16.5) Atrial fibrillation (No.) (%) 70 (29.7) 37 (29.1) Previous stroke (No.) (%) 22 (9.3) 11 (8.7) Time from symptom onset to CTP study (median) (IQR) (min) 167 (88–270) 150 (77–281) Time from CTP to MRI study (median) (IQR) (hr) 34.9 (22.5–61.3) 30.9 (20.9–62.2) TOAST (No.) (%)33 Atherosclerotic 35 (14.8) 22 (12.7) Cardioembolic 120 (50.8) 63 (49.6) Undetermined 67 (28.4) 36 (28.3) Infrequent 14 (6) 6 (4.7) mTICI score (No.) (%) 0 21 (8.9) 0 (0) 1 7 (3) 0 (0) 2a 18 (7.6) 0 (0) 2b 63 (26.7) 0 (0) 3 127 (53.8) 127 (100) Collateral status (median) (IQR) 2 (1–3) 2 (2–3) CBF (median) (IQR) (mL/100 g/min) 2.4 (2.2–2.6) 2.4 (2.2–2.6) CBV (median) (IQR) (mL/100 g/min) 24.3 (20.5–26.9) 24.3 (20.5–26.5) MTT (median) (IQR) (sec) 6.0 (5.5–6.5) 6.1 (5.5–6.6) NVT (median) (IQR) (mL) 19.3 (8.0–34.5) 16.0 (7.4–33.0) FIV (median) (IQR) (mL) 19.6 (7.4–51.0) 14.0 (3.6–58.4) Note:—mTICI indicates modified TICI.
- Table 2:
Baseline traits and volumetric differences among PVH scores on MRI in patients achieving complete reperfusion after mechanical thrombectomy (n = 126)
PVH 0 PVH 1 PVH 2 PVH 3 P Value Age (mean) (SD) (yr) 59.0 (16.7) 68.0 (12.2) 76.6 (7.7) 72.9 (15.3) <.001 Baseline NIHSS score (median) (IQR) 16 (11–19) 16 (11–20) 18 (8–20) 17 (13–21) .921 Time from symptom onset to CTP study (median) (IQR) (min) 154 (89–233) 168 (92–296) 135 (64–263) 185 (73–385) .871 CBF (median) (IQR) (mL/100 g/min) 2.4 (2.2–2.7) 2.4 (2.1–2.6) 2.5 (2.2–2.7) 2.4 (2.2–2.8) .558 CBV (median) (IQR) (mL/100 g/min) 25.4 (22.9–28.1) 23.9 (21.0–26.1) 23.1 (19.4–26.9) 22.6 (18.0–28.0) .205 MTT (median) (IQR) (sec) 5.7 (5.3–6.3) 6.0 (5.4–6.3) 6.2 (5.8–6.7) 6.4 (6.3–7.1) .021 Collateral status (median) (IQR) 2 (2–3) 2 (2–3) 2 (2–3) 2 (1–2) .174 NVT (median) (IQR) (mL) 15.4 (7.3–32.0) 16.0 (7.8–36.3) 15.4 (3.5–31.4) 23.1 (15.1–33.9) .411 FIV (median) (IQR) (mL) 15.0 (3.5–32.4) 12.8 (5.3–19.8) 14.3 (2.8–40.0) 13.6 (1.3–25.8) .826 Volumetric biasa (median) (IQR) (mL) using Fazekas score on MRI 4.2 (−18.5–9.8) 1.6 (−3.1–16.4) 0.0 (−18.7–16.0) 12.5 (0.9–30.4) .205 Volumetric biasa (median) (IQR) (mL) using Fazekas score on NCCT 2.6 (−12.1–11.6) 2.3 (−3.5–13.2) 0.5 (−18.7–14.5) 11.4 (−1.1–31.4) .557 ↵a Volumetric bias was defined as NVT (using the rCBF <30% cutoff)-FIV.
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