Tmax Parameter From CT Perfusion Predicts The Prognosis Of Patients With Acute Ischemic Stroke After Thrombolysis

Background and Purpose Time-to-maximum(Tmax)from computed tomography perfusion(CTP)can used to predict the early reperfusion and brain tissue outcome in patients with acute ischemic stroke.This study aims to show that the clinical prognosis of acute ischemic stroke after rt-PA thrombolysis can predicted by Tmax and Tmax-time index from CT perfusion.Methods We screened patients who underwent CTP imaging scan from March 2014 through September 2017.Patients with acute anterior ischemic stroke who treated with rt-PA thrombolysis and underwent CT perfusion imaging within 48 hours of thrombolysis enrolled.All of those patients followed up for 3 months.The association of Tmax,Tmax-time index with 90 day Modified Rankin Scale(mRS)?1 were examined using receive operating characteristic analysis(ROC)and Cox regression model analysis.Results Of 47 patients,26 were treated with rt-PA thrombolysis and underwent CT perfusion within 48 hours of thrombolysis;of which 7(26.9%)patients 90 days mRS?1.ROC revealed that Tmax<1.25s(AUC=0.805,P=0.019),Tmax/time<1.08(AUC=0.842,P=0.009)were the optimal thresholds.Tmax<1.25 s is prediction of 90 days mRS?1 with sensitivity of 94.7%,specificity of 57.1%.Tmax/time is prediction of 90 days mRS?1 with sensitivity of 89.5%,specificity of 85.7%.Tmax/time<1.08 is independently predictive of 90 days mRS?1 in Multivariate analysis with the Cox regression models(P<0.05).Conclusions Tmax and Tmax-time index from CT perfusion imaging can predict the clinical prognosis of patients with acute ischemic stroke after thrombolysis,and there is no significant difference in the accuracy of the two parameters.