Prediction of the long-term efficacy of STA-MCA bypass by DSC-PI

Superficial temporal artery-middle cerebral artery (STA-MCA) bypass [1,2] is an important and effective type of surgical revascularization that is widely used in the treatment of ischemic cerebral artery disease. However, a means of predicting its postoperative efficacy has not been established [3,4...

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Autores principales: Hui Li, Hui Liu, Tong Han
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Publicado: De Gruyter 2016
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spelling oai:doaj.org-article:e1c6a390b9d64e448713c20526be240e2021-12-05T14:11:04ZPrediction of the long-term efficacy of STA-MCA bypass by DSC-PI2081-693610.1515/tnsci-2016-0017https://doaj.org/article/e1c6a390b9d64e448713c20526be240e2016-01-01T00:00:00Zhttps://doi.org/10.1515/tnsci-2016-0017https://doaj.org/toc/2081-6936Superficial temporal artery-middle cerebral artery (STA-MCA) bypass [1,2] is an important and effective type of surgical revascularization that is widely used in the treatment of ischemic cerebral artery disease. However, a means of predicting its postoperative efficacy has not been established [3,4]. The present study analyzes the correlation between preoperative perfusion parameters (obtained using dynamic susceptibility contrast-enhanced perfusion imaging, DSC-PI) and postoperative long-term prognosis (using modified Rankin Scale, mRS scores). The preoperative perfusion parameters were defined by a combination of perfusion-weighted imaging and the Alberta Stroke Program Early Computerized Tomography Score (PWI-ASPECTS) and included cerebral blood flow (CBF)-ASPECTS, cerebral blood volume (CBV)-ASPECTS, mean transit time (MTT)-ASPECTS, and time to peak (TTP)-ASPECTS. Preoperative and postoperative scores were determined for 33 patients that received a unilateral STA-MCA bypass in order to discover the most reliable imaging predictive index as well as to define the threshold value for a favorable clinical outcome. The results showed that all of the PWI-ASPECTS scores were significantly negatively correlated with clinical prognosis. Receiver operating curve (ROC) analysis of the preoperative parameters in relation to long term prognosis showed the area under curve (AUC) was maximal for the CBF-ASPECTS score (P = 0.002). A preoperative score of less than six indicated a poor postoperative prognosis (sensitivity = 74.1%, specificity = 100%, AUC = 0.843). In conclusion, preoperative PWI-ASPECTS scores have been found useful as predictive indexes for the long-term prognosis of STA-MCA bypass patients, with higher scores indicating better postoperative long-term outcomes. As the most valuable prognostic indicator, the preoperative CBF-ASPECTS score has potential for use as a major index in screening and outcome prediction of patients under consideration for STA-MCA bypass surgery.Hui LiHui LiuTong HanDe Gruyterarticlealberta stroke program early computerized tomography score (aspects)long-term predictionmagnetic resonance imaging (mri)perfusion imagingsuperficial temporal artery – middle cerebral artery (sta-mca) bypassNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENTranslational Neuroscience, Vol 7, Iss 1, Pp 110-115 (2016)
institution DOAJ
collection DOAJ
language EN
topic alberta stroke program early computerized tomography score (aspects)
long-term prediction
magnetic resonance imaging (mri)
perfusion imaging
superficial temporal artery – middle cerebral artery (sta-mca) bypass
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
spellingShingle alberta stroke program early computerized tomography score (aspects)
long-term prediction
magnetic resonance imaging (mri)
perfusion imaging
superficial temporal artery – middle cerebral artery (sta-mca) bypass
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Hui Li
Hui Liu
Tong Han
Prediction of the long-term efficacy of STA-MCA bypass by DSC-PI
description Superficial temporal artery-middle cerebral artery (STA-MCA) bypass [1,2] is an important and effective type of surgical revascularization that is widely used in the treatment of ischemic cerebral artery disease. However, a means of predicting its postoperative efficacy has not been established [3,4]. The present study analyzes the correlation between preoperative perfusion parameters (obtained using dynamic susceptibility contrast-enhanced perfusion imaging, DSC-PI) and postoperative long-term prognosis (using modified Rankin Scale, mRS scores). The preoperative perfusion parameters were defined by a combination of perfusion-weighted imaging and the Alberta Stroke Program Early Computerized Tomography Score (PWI-ASPECTS) and included cerebral blood flow (CBF)-ASPECTS, cerebral blood volume (CBV)-ASPECTS, mean transit time (MTT)-ASPECTS, and time to peak (TTP)-ASPECTS. Preoperative and postoperative scores were determined for 33 patients that received a unilateral STA-MCA bypass in order to discover the most reliable imaging predictive index as well as to define the threshold value for a favorable clinical outcome. The results showed that all of the PWI-ASPECTS scores were significantly negatively correlated with clinical prognosis. Receiver operating curve (ROC) analysis of the preoperative parameters in relation to long term prognosis showed the area under curve (AUC) was maximal for the CBF-ASPECTS score (P = 0.002). A preoperative score of less than six indicated a poor postoperative prognosis (sensitivity = 74.1%, specificity = 100%, AUC = 0.843). In conclusion, preoperative PWI-ASPECTS scores have been found useful as predictive indexes for the long-term prognosis of STA-MCA bypass patients, with higher scores indicating better postoperative long-term outcomes. As the most valuable prognostic indicator, the preoperative CBF-ASPECTS score has potential for use as a major index in screening and outcome prediction of patients under consideration for STA-MCA bypass surgery.
format article
author Hui Li
Hui Liu
Tong Han
author_facet Hui Li
Hui Liu
Tong Han
author_sort Hui Li
title Prediction of the long-term efficacy of STA-MCA bypass by DSC-PI
title_short Prediction of the long-term efficacy of STA-MCA bypass by DSC-PI
title_full Prediction of the long-term efficacy of STA-MCA bypass by DSC-PI
title_fullStr Prediction of the long-term efficacy of STA-MCA bypass by DSC-PI
title_full_unstemmed Prediction of the long-term efficacy of STA-MCA bypass by DSC-PI
title_sort prediction of the long-term efficacy of sta-mca bypass by dsc-pi
publisher De Gruyter
publishDate 2016
url https://doaj.org/article/e1c6a390b9d64e448713c20526be240e
work_keys_str_mv AT huili predictionofthelongtermefficacyofstamcabypassbydscpi
AT huiliu predictionofthelongtermefficacyofstamcabypassbydscpi
AT tonghan predictionofthelongtermefficacyofstamcabypassbydscpi
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