Diagnostic accuracy of computed tomography brain perfusion in the prediction of acute ischemic stroke taking the findings of MRI as gold standard.

Abstract

Objectives: To determine the diagnostic accuracy of computed tomography brain perfusion to predict acute ischemic stroke taking the findings of MRI as gold standard. Study Design: Cross-sectional Validation study. Setting: Department of Radiology Allied Hospital Faisalabad. Period: 20^th May 2022 to 19^th November 2022. Material & Methods: A total of 215 individuals, aged between 30 and 70, of both sexes, and exhibiting ischemic stroke symptoms lasting no more than 12 hours, were included. Patients with abnormal renal function tests having renal disease were excluded. The conventional non-contrast CT used in the CT stroke protocol had basal sections that were either 3 mm or 4 mm in thickness and supra tentorial sections that were either 3 mm or 4 mm in thickness. The acquisition parameters were 80kVp and 120mAs. Dynamic CT perfusion was carried out with 4 cm plane coverage. At the seventh day, all patients underwent a follow-up MRI using a 1.5 Tesla Philips MRI scanner. A radiologist examined CTP to look for signs of early ischemic changes. For CT perfusion (CTP), measurements were taken for time to peak (TTP), cerebral blood flow (CBF), and cerebral blood volume (CBV). Results: Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of computed tomography brain perfusion in the prediction of acute ischemic stroke taking the findings of MRI as gold standard was 85.37%, 76.09%, 82.68%, 79.55% and 81.40% respectively. Conclusion: This study led to the conclusion that diagnostic accuracy of computed tomography brain perfusion to predict acute ischemic stroke is quite high.