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Prediction of Hemorrhagic Transformation in Acute Ischemic Stroke by

Perfusion Computed Tomography

Pichest Metarugcheep MD., Tasanee Tantirittisak MD., Somsak Chanyawattiwongs Msc.

Prasat Neurological Institute, Department of medical Sevices,

Ministry of Health, Bangkok, Thailand

Background: Hemorrhagic transformation (HT) may deteriorate the outcome

of acute ischemic stroke (AIS) .The aim of this study was to determine whether

increase microvascular permeability (PS) of the blood-brain- barrier (BBB) could

be found in early AIS by using first pass dynamic perfusion computed

tomography(PCT) and a predictor of HT

Materials and methods: Thirty patients with AIS less than 4.5 hrs old were

enrolled into the study, PS color maps were prospectively generated from

PCT data using Patlak model. One reader study each PS map by drawing 2

circulars (size about 10 mms in diameter) of the region of interest on any focal

abnormality .The mean of these 2 regions of interest represent the PS of the

infarct (PS infarct ).The mean of 2 mirror regions of interest on the non- ischemic

contra lateral hemisphere were also obtained (PS control ). PS infarct and PS control

were compared with each other using T- test as well as the PS that become

HT
hemorrhagic transformation (PS )and that not (PS NOHT )

Result: Twenty infarcts (67%)shows focal PS elevation in the region of infarct in

unites of mL / 100 mLs / minute, PS infarct ranged from 2.9 to 13.0(mean

4.5±3.3)versus PS control of 0.0-0.9(Mean0.3±0.3) ,five patient (16.7%)developed

th
19 Annual Academic Meeting of Prasat Neurological Institute, 2015