Untersuchungen zum prognostischen Wert der Ganzhirn-Volumen-Perfusions-CT bei Patienten mit akuter zerebraler Ischämie

Finger, Sarah

dc.contributor.advisor	Schramm, Peter Prof. Dr.
dc.contributor.author	Finger, Sarah
dc.date.accessioned	2016-10-25T13:39:51Z
dc.date.available	2016-11-10T23:50:06Z
dc.date.issued	2016-10-25
dc.identifier.uri	http://hdl.handle.net/11858/00-1735-0000-002B-7C46-7
dc.identifier.uri	http://dx.doi.org/10.53846/goediss-5924
dc.language.iso	deu	de
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.ddc	610	de
dc.title	Untersuchungen zum prognostischen Wert der Ganzhirn-Volumen-Perfusions-CT bei Patienten mit akuter zerebraler Ischämie	de
dc.type	doctoralThesis	de
dc.title.translated	Prognostic value of the whole-brain volume perfusion CT in acute stroke < 6 hours after symptom onset	de
dc.contributor.referee	Liman, Jan Dr.
dc.date.examination	2016-11-03
dc.description.abstracteng	Background and Purpose: In the dissertation we examined the prognostic value of whole-brain volume perfusion computed tomography (VPCT) using a 128-slice multi-detector CT in patients with acute ischemic stroke within 6 hours of symptom onset. The hypothesis was tested that whole-brain VPCT applied to an acute stroke event shows a high prognostic value regarding the final extent of the stroke. Methods: Analysis of 28 patients with an acute ischemic stroke who underwent non-contrast CCT, CT angiography and VPCT. The infarct volume on VPCT was compared to the infarct size on follow-up images (CT or MRI) performed within three days later (on average). For the subgroup analysis patients were dichotomised: Patients with a visable intracranial arterial vessel occlusion were distiguished from those not showing a vessel occlusion. Moreover patients were divided, depending on the severity of the symptoms, into groups with a NIHSS score of < 8 or ≥ 8. The prognostic value was evaluated on the basis of the CT perfusion maps for time to peak (TTP), cerebral blood flow (CBF), cerebral blood volume (CBV) and cerebral blood volume using patlak analysis (CBV(P)). Furthermore the parameters tissue at risk (TAR) and non-viable tissue (NVT), defined by absolute threshold values, were evaluated. The evaluation of the CT perfusion maps was carried out after manually specifying the region of interest. The volumes determined in this way could hence be directly compared with the follow-up images. Results: The extent of the ischemic lesion on the CT parameter maps of CBV and the combination of TAR and NVT resulted in the highest prognostic value. The division into subgroups did not have any influence on the statistical significance of the results. Conclusion: Using VPCT (especially the CBV map) in acute stroke patients is suitable for rapid and accurate quantification of the final infarct volume. The CBV is therefore a prognostic parameter which should be evaluated in further studies to assess its impact on therapeutic decision.	de
dc.contributor.coReferee	Meyer, Thomas Prof. Dr.
dc.subject.ger	Ganzhirn-Volumen-Perfusions-CT	de
dc.subject.ger	akuter Schlaganfall	de
dc.subject.ger	zerebrales Blutvolumen	de
dc.subject.eng	whole-brain perfusion ct	de
dc.subject.eng	acute stroke	de
dc.subject.eng	cerebral blood volume	de
dc.identifier.urn	urn:nbn:de:gbv:7-11858/00-1735-0000-002B-7C46-7-5
dc.affiliation.institute	Medizinische Fakultät	de
dc.subject.gokfull	Medizin (PPN619874732)	de
dc.description.embargoed	2016-11-10
dc.identifier.ppn	870991825