Aim To investigate the prognostic utility of comprehensive evaluation using CT perfusion imaging for predicting long-term functional outcomes in anterior circulation acute ischemic stroke (AIS) patients. Methods In this retrospective study, 132 patients with anterior circulation AIS who underwent CT perfusion imaging within 24 h from symptom onset were included. Patients were categorized into favorable (Barthel score ≥60) and unfavorable (Barthel score<60) outcomes groups based on 3-month modified Barthel Scale scores. Analyze and compare infarct characteristics, perfusion parameters cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (Tmax), permeability surface-area product (PS) and clinical data of two groups, and assess predictive performance. Clinical variables age, National Institutes of Health Stroke Scale (NIHSS), time to imaging, pre-existing conditions were also compared but not integrated into the final combined model, which focused on CTP parameters alone. Results Patients with unfavorable outcomes exhibited significantly larger infarct volumes, greater perfusion deficits, and larger lesion volumes on imaging. CT perfusion revealed distinct hemodynamic patterns between groups. CBF, MTT, Tmax and PS all significantly correlated with outcomes. A combined predictive model based on CT perfusion parameters achieved excellent predictive accuracy (AUC 0.968), which was validated in a temporally distinct cohort (AUC = 0.964). Conclusion Comprehensive evaluation integrating CT perfusion imaging provides robust prognostic information beyond individual perfusion parameters. Hemodynamic parameters are significantly associated with long-term functional status and may serve as valuable prognostic biomarkers to guide clinical management of anterior circulation AIS patients.
Jing et al. (Tue,) studied this question.
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