Study of correlations between CT properties of retrieved cerebral thrombi with treatment outcome of stroke patients

Abstract Background All the patients with suspected stroke are directed to whole-brain CT scan. The purpose of this scan is to look for early features of ischemia and to rule out alternative diagnoses than stroke. In case of ischemic stroke, CT diagnostics (including CT angiography) is used mainly to locate the occlusion and its size, while the Hounsfield Units (HU) values of the thrombus causing the stroke are usually overlooked on CT scan or considered not important. The aim of this study was to demonstrate that the HU value is relevant and can help in better treatment planning. Patients and methods There were 25 patients included in the study, diagnosed with ischemic stroke in the middle cerebral artery (MCA) territory. In all patients, systemic thrombolysis was not successful and the mechanical recanalization was needed. The retrieved thrombi were also analyzed histologically for the determination of red blood cells (RBC) proportion. CT of the proximal MCA (M1) segment was analyzed for average HU value and its variability both in the occluded section and the symmetrical normal site. These CT parameters were then statistically studied for the possible correlations with different clinical, histological and procedure parameters using the Linear Regression and the Pearson correlation coefficient. Results Relevant positive correlations were found between average HU value of thrombus and outcome modified Rankin Scale (mRS), initial mRS, number of passes with thrombectomy device as well as RBC proportion. Conclusions Results of the present study suggest that measured HU values in CT images of the cerebral thrombi may help in the assessment of thrombus compaction and therefore better treatment planning.

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KORELASI KADAR LAJU ENDAP DARAH DENGAN NILAI ASPECTS PADA PASIEN STROKE ISKEMIK

Majalah Kedokteran Andalas ◽

10.22338/mka.v38.i1.p26-32.2015 ◽

2015 ◽

Vol 38 (1) ◽

pp. 26

Author(s):

Ratih Ismiranti Murni ◽

Dwi Pudjonarko ◽

Bambang Satoto ◽

Sukma Imawati

Keyword(s):

Diabetes Mellitus ◽

Ischemic Stroke ◽

Ct Scan ◽

Acute Ischemic Stroke ◽

Clinical Manifestations ◽

Stroke Patients ◽

Cross Sectional ◽

Emergency Imaging ◽

Brain Ct Scan ◽

Relationship Of

AbstrakStroke adalah penyebab utama ke-3 kematian di Amerika Serikat. Stroke iskemik adalah kondisi kompleks dengan etiologi dan manifestasi klinis bervariasi. CT Scan kepala adalah pencitraan darurat stroke membedakan dengan perdarahan intrakranial. Beberapa peneliti mengemukakan adanya korelasi independent dan hubungan pemeriksaan rutin biomarkers pada pasien stroke iskemik akut termasuk di dalamnya parameter inflamasi yang berperan pada patofisiologi iskemia otak. Tujuan penelitian ini mengetahui korelasi kadar LED dengan penilaian ASPECTS pada pasien stroke iskemik. Penelitian ini merupakan penelitian observasional analitik belah lintang dari catatan rekam medik. Selama periode Desember 2012 - Oktober 2014. Didapatkan 16 sampel yang memenuhi kriteria inklusi dan ekslusi. Dengan beberapa karakteristik subyek penelitian meliputi usia, jenis kelamin, hipertensi, diabetes mellitus, dislipidemia, kadar LED 1 dan 2, awitan stroke iskemik akut. Uji statistik Rank Spearman’s,dan uji bivariat maupun multivariat. Didapatkan hasil tidak ada korelasi antara nilai ASPECTS dengan kadar LED dan faktor yang mempengaruhi nilai ASPECTS.AbstractStroke is the third major cause of death in United States. Ischemic stroke results from complex conditions with various etiologies and clinical manifestations. Brain CT Scan is a stroke emergency imaging to differentiate intracranial hemorrhage. Several studies claimed there were independent correlation and relationship of biomarker in routine examination of acute ischemic stroke patients including inflammation parameters that contribute to the pathophysiology of brain ischemic. The purpose in this study was to identify correlation between ESR level and ASPECTS in ischemic stroke patients. The method of study was analytical observational cross sectional taken from medical record. It was performed in 16 patients that fulfill the inclusion and exclusion criteria during December 2012- October 2014. Several characteristics of subject that affecting ASPECTS included age, gender, hypertention, diabetes mellitus, dyslipidemia, ESR level 1 and 2, and onset of acute ischemic stroke were assessed. Analytical test was performed by Rank spearman’s test and multivariate test. There was no correlation between ASPECTS with ESR level and factors that affect ASPECTS.

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The correlation between brain CT scan and the oxfordshire community stroke project (OCSP) classification in acute ischemic stroke

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/s1052-3057(97)80163-2 ◽

1997 ◽

Vol 6 (6) ◽

pp. 466

Author(s):

Amira R Al-Buhairi ◽

Stephen Phillips ◽

Grant Llewellyn ◽

Mohammed MS Jan

Keyword(s):

Ischemic Stroke ◽

Ct Scan ◽

Acute Ischemic Stroke ◽

Brain Ct ◽

Oxfordshire Community Stroke Project ◽

Brain Ct Scan

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Relationship of Common Carotid Artery High Intensity Transient Signals in Patients with Ischemic Stroke to White Matter versus Territorial Infarct Pattern on Brain CT Scan

Cerebrovascular Diseases ◽

10.1159/000107837 ◽

1995 ◽

Vol 5 (2) ◽

pp. 128-132 ◽

Cited By ~ 4

Author(s):

Charles H. Tegeler ◽

Volker A. Knappertz ◽

Dindajur Nagaraja ◽

Marilyn Mooney ◽

Gary M. Dalley

Keyword(s):

Ischemic Stroke ◽

White Matter ◽

Carotid Artery ◽

Ct Scan ◽

Common Carotid Artery ◽

High Intensity ◽

Transient Signals ◽

Brain Ct ◽

Brain Ct Scan ◽

Relationship Of

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BRAIN CT SCAN IN ACUTE ISCHEMIC STROKE: EARLY SIGNS AND FUNCTIONAL OUTCOME

Clinical and Experimental Hypertension ◽

10.1081/ceh-120015345 ◽

2002 ◽

Vol 24 (7-8) ◽

pp. 687-696 ◽

Cited By ~ 3

Author(s):

Nicola Tambasco ◽

Francesco Corea ◽

Roberto Luccioli ◽

Ettore Ciorba ◽

Lucilla Parnetti ◽

...

Keyword(s):

Ischemic Stroke ◽

Ct Scan ◽

Acute Ischemic Stroke ◽

Functional Outcome ◽

Brain Ct ◽

Early Signs ◽

Brain Ct Scan

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SYSTEMIC THROMBOLYSIS IN ACUTE ISCHEMIC STROKE AFTER DABIGATRAN ETEXILATE REVERSAL WITH IDARUCIZUMAB – A CASE REPORT

10.26226/morressier.58e389b3d462b802923848e2 ◽

2017 ◽

Author(s):

Derya Tireli

Keyword(s):

Ischemic Stroke ◽

Case Report ◽

Acute Ischemic Stroke ◽

Dabigatran Etexilate ◽

Systemic Thrombolysis

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Combined effect of hypertension and hyperuricemia on ischemic stroke in a rural Chinese population

BMC Public Health ◽

10.1186/s12889-021-10858-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Peng Sun ◽

Mengqi Chen ◽

Xiaofan Guo ◽

Zhao Li ◽

Ying Zhou ◽

...

Keyword(s):

Ischemic Stroke ◽

Missing Data ◽

Chinese Population ◽

Joint Effect ◽

Cross Sectional Study ◽

Combined Effect ◽

Sectional Study ◽

Cross Sectional ◽

Current Smoking ◽

Positive Correlations

Abstract Background To investigate the combined effect of hypertension and hyperuricemia to the risk of ischemic stroke in a rural Chinese population. Methods The cross-sectional study was conducted from 2012 to 2013 in a rural area of China. After exclusion for missing data, we finally included 11,731 participants into analysis. Results After adjusting for age, current smoking, current drinking, BMI, TG, HDL-C and eGFR, hypertension was significantly associated with ischemic stroke in men (OR: 2.783, 95% CI: 1.793, 4.320) and in women (OR: 4.800, 95% CI: 2.945, 7.822). However, hyperuricemia was significantly associated with ischemic stroke only in women (OR: 1.888, 95% CI: 1.244, 2.864). After full adjustment, participants with both hypertension and hyperuricemia had 8.9 times higher risk than those without them. Finally, the interaction between hypertension and hyperuricemia was statistically significant only in women rather than in men after full adjustment. Conclusions This study demonstrated the positive correlations between hypertension, hyperuricemia and ischemic stroke. Our study also demonstrated the joint effect between hypertension and hyperuricemia towards ischemic stroke only in women, not in men.

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Calcium Identification and Scoring Based on Echocardiography. An Exploratory Study on Aortic Valve Stenosis

Journal of Personalized Medicine ◽

10.3390/jpm11070598 ◽

2021 ◽

Vol 11 (7) ◽

pp. 598

Author(s):

Luis B. Elvas ◽

Ana G. Almeida ◽

Luís Rosario ◽

Miguel Sales Dias ◽

João C. Ferreira

Keyword(s):

Aortic Valve ◽

Ct Scan ◽

Pearson Correlation ◽

Region Of Interest ◽

Expert Assessment ◽

Image Binarization ◽

Real Patient ◽

Margin Of Error ◽

Pixel Value ◽

Echocardiographic Images

Currently, an echocardiography expert is needed to identify calcium in the aortic valve, and a cardiac CT-Scan image is needed for calcium quantification. When performing a CT-scan, the patient is subject to radiation, and therefore the number of CT-scans that can be performed should be limited, restricting the patient’s monitoring. Computer Vision (CV) has opened new opportunities for improved efficiency when extracting knowledge from an image. Applying CV techniques on echocardiography imaging may reduce the medical workload for identifying the calcium and quantifying it, helping doctors to maintain a better tracking of their patients. In our approach, a simple technique to identify and extract the calcium pixel count from echocardiography imaging, was developed by using CV. Based on anonymized real patient echocardiographic images, this approach enables semi-automatic calcium identification. As the brightness of echocardiography images (with the highest intensity corresponding to calcium) vary depending on the acquisition settings, echocardiographic adaptive image binarization has been performed. Given that blood maintains the same intensity on echocardiographic images—being always the darker region—blood areas in the image were used to create an adaptive threshold for binarization. After binarization, the region of interest (ROI) with calcium, was interactively selected by an echocardiography expert and extracted, allowing us to compute a calcium pixel count, corresponding to the spatial amount of calcium. The results obtained from these experiments are encouraging. With this technique, from echocardiographic images collected for the same patient with different acquisition settings and different brightness, obtaining a calcium pixel count, where pixel values show an absolute pixel value margin of error of 3 (on a scale from 0 to 255), achieving a Pearson Correlation of 0.92 indicating a strong correlation with the human expert assessment of calcium area for the same images.

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