Abstract
The presence of intraparenchymal hyperattenuations (IPH) on flat-panel computed tomography (FP-CT) after endovascular recanalization in stroke patients is acommon phenomenon. They are thought to occur in ischemic areas with breakdown of the blood-brain barrier but previous studies that investigated amutual interaction are scarce. We aimed to assess the relationship of IPH localization with prethrombectomy diffusion-weighted imaging (DWI) lesions. This retrospective multicenter study included 27 acute stroke patients who underwent DWI prior to FP-CT following mechanical thrombectomy. After software-based coregistration of DWI and FP-CT, lesion volumetry was conducted and overlapping was analyzed. Two different patterns were observed: IPH corresponding to the DWI lesion and IPH exceeding the DWI lesion. The latter showed demarcated infarction of DWI exceeding IPH at 24h. No major hemorrhage following IPH was observed. Most IPH were manifested within the basal ganglia and insular cortex. The IPH primarily appeared within the initial ischemic core and secondarily within the penumbral tissue that progressed to infarction. The IPH represent the minimum final infarct volume, which may help in periinterventional decision making.
Published Version
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