AI Article Synopsis
- The study investigated the relationship between mean transit time (MTT) and stroke risk in patients with complete carotid artery occlusion using imaging techniques to measure cerebral blood flow.
- Results showed that a higher MTT ratio significantly increased the risk of experiencing an ipsilateral stroke, with a cutpoint ratio of 1.387 identified as critical for risk assessment.
- Patients with an MTT ratio of 1.387 or greater had a 29.3% risk of stroke over two years, highlighting the need for further research across different imaging methods to confirm these findings.
Article Abstract
Background: Mean transit time (MTT) measurements to assess cerebral hemodynamics are easily obtained by computed tomography and magnetic resonance imaging. We reviewed hemodynamic and clinical outcome data from the St. Louis Carotid Occlusion Study to determine if increased MTT was associated with an increased risk of stroke in patients with symptomatic complete carotid artery occlusion.
Methods: Positron emission tomography (PET) studies of cerebral blood volume-to-cerebral blood flow ratios were used to calculate MTTs. Mean ipsilateral (side of the occluded internal carotid artery)-to-contralateral ratios of MTTs in the middle cerebral artery territories were determined. MTT was tested as a predictor of stroke risk using Cox regression analysis. Receiver operating characteristic curves for stroke risk prediction were generated by varying the mean ispilateral-to-contralateral MTT ratio to identify an optimal cutpoint.
Results: Increased MTT ratio was associated with an increased risk of ipsilateral stroke (P < .001). The maximum combination of sensitivity (.778) and specificity (.763) was obtained at a cutpoint ratio of 1.387 or higher. Subjects with a MTT ratio of 1.387 or higher had a 29.3% 2-year risk of ipsilateral stroke compared to 4.6% for those without (P < .001).
Conclusions: PET relative MTT ratio identified patients with symptomatic complete internal artery occlusion who were at high risk for subsequent ipsilateral stroke. Confirmation using measurements of relative MTT from other imaging modalities in a patient cohort receiving contemporary medical management is needed.
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| http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2015.12.041 | DOI Listing |
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