Study on the relationship among multi-slice CT perfusion and National Institutes of Health Stroke Scale Score and clinical outcome in patients at hyperacute stroke

Abstract

Objective To investigate the correlation of multi-slice CT (MSCT) perfusion with the clinical condition at hyperacute stroke and clinical outcome. Methods MSCT perfusion was performed in 25 patients with acute ischemic stroke within 6 hours of symptom onset. Follow-up CT or MRI was performed in 23 patients 30-40 days after symptom onset. A potential recuperation ratio, defined as PRR=penumbra size / (penumbra size + infarct size) on the admission perfusion CT, was compared with the evaluation in each patient′s clinical condition, and the National Institutes of Health Stroke Scale (NIHSS) was scored. The correlation of NIHSS with PRR and perfusion results was studied. Results (1) Linear regression of initial NIHSS was: Y=-3.12+6.70 X_1+0.001 X_2+4.21 X_3, X_1 was complication (No X_1=1, Yes X_1=2) (t=4.77,P=0.000), X_2 was the size of CBF (t=2.69,P=0.015), X_3 was the location (ACA or PCA X_3=1, MCA X_3=2)(t=2.44,P=0.026). (2) Linear regression of NIHSS in clinical outcome was: Y=2.62+6.26X_1-0.23X_2, X_1 was complication (No X_1=1, Yes X_1= 2) (t=4.15,P=0.001), X_2 was severity of ischemia (t=-2.64,P=0.016). (3) The PRR correlated with the improvement in the NIHSS evaluated on admission and after a month(r=0.502,P=0.020). Conclusion (1) There is no correlation between NIHSS and CT perfusion in this study, which indicates that the NIHSS score may relate to complex factors. (2) MSCT perfusion study may provide information about the extent of the penumbra. MSCT perfusion could therefore be a valuable tool in predicting clinical prognosis.