Abstract Details

Title Diagnostic Utility of Computed Tomography Perfusion in Acute Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (11:45 AM-12:45 PM)

Poster/Presentation
Number 14-012

Objective To assess the sensitivity and specificity of CTP compared with follow-up MRI in acute ischemic stroke.

Background CTP is highly sensitive and specific for anterior circulation large vessel occlusion (LVO), but its utility in distal medium vessel occlusion (DMVO) and small infarcts is questionable.

Design/Methods Data were collected from 115 cases of adult patients aged >18 presenting with acute strokes at our institution between 2020-2023. We included DMVO and non-LVO strokes. Non-LVO strokes comprise all patients without LVO and DMVO. Ischemia on initial CT perfusion scans was compared to strokes on follow-up MRI scans.

The analysis included descriptive statistical analysis as well as logistic regression models given a binary outcome variable. Logistic regression analyses were run of the main cohorts and a subgroup constituting individuals with DMVO and non-LVO strokes. The significance level was set at 0.05.

Results

There were a total of 115 patients with a mean age of 62.36 with 49.57% males.

The sensitivity and specificity of initial CTP to detect strokes on subsequent MRI were 73.02% and 55.77%, respectively.

Univariate analysis revealed a statistically significant association between initial CTP and subsequent MRI for all patients (OR = 3.41; 95% CI: 1.56 – 7.45; p = 0.02). Multivariable analysis was statistically insignificant (OR = 1.62; 95% CI: 0.43 – 6.12; p = 0.48).

Univariate regression analysis of the non-LVO subgroup revealed a statistically insignificant association between initial CTP and subsequent MRI (OR = 1.42; 95% CI: 0.6 – 3.36; p = 0.42). Multivariable analysis also revealed insignificant results (OR = 1.07; 95% CI: 0.26 – 4.39; p = 0.92).

Conclusions We found a statistically significant association between CTP and MRI findings in the main cohorts during univariable analysis. However, the subgroup analysis showed a statistically nonsignificant difference. Further studies with larger sample sizes are needed to evaluate this association.

Authors/Disclosures
Gautam Gullapalli, MBBS (The View Tower) PRESENTER	No disclosure on file
Muhammad Khalid, MD (LSU shreveport)	Dr. Khalid has nothing to disclose.
Muhammad Ayub, MD (Louisiana State University, Shreveport)	Dr. Ayub has nothing to disclose.
Mohammad A. Sheikh, MBBS (LSU Health Shreveport)	Dr. Sheikh has nothing to disclose.
Monika Thapa, MBBS (Department of Neurology)	Dr. Thapa has nothing to disclose.
Pankaj Sharma, MD	Dr. Sharma has nothing to disclose.

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