1. Clinical and imaging predictors of intracerebral haemorrhage in stroke patients treated with intravenous tissue plasminogen activator
- Author
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Norbert Nighoghossian, Frédéric Philippeau, Marlène Wiart, Jérôme Honnorat, Laurent Derex, Jean-Baptiste Pialat, Paul Trouillas, Jean-Claude Froment, Patrice Adeleine, Yves Berthezène, Marc Hermier, Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Creatis, Compte Général, Centre de Recherche et d'Application en Traitement de l'Image et du Signal (CREATIS), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-École Supérieure Chimie Physique Électronique de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Male ,[SPI.OPTI] Engineering Sciences [physics]/Optics / Photonic ,[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging ,[INFO.INFO-IM] Computer Science [cs]/Medical Imaging ,030204 cardiovascular system & hematology ,Tissue plasminogen activator ,Brain Ischemia ,Brain ischemia ,0302 clinical medicine ,[INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing ,Prospective Studies ,Infusions, Intravenous ,Stroke ,Univariate analysis ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,medicine.diagnostic_test ,Middle Aged ,[PHYS.MECA.ACOU]Physics [physics]/Mechanics [physics]/Acoustics [physics.class-ph] ,3. Good health ,[SPI.ELEC]Engineering Sciences [physics]/Electromagnetism ,Psychiatry and Mental health ,Cerebral blood flow ,[INFO.INFO-TI] Computer Science [cs]/Image Processing [eess.IV] ,[INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV] ,Tissue Plasminogen Activator ,[PHYS.PHYS.PHYS-MED-PH]Physics [physics]/Physics [physics]/Medical Physics [physics.med-ph] ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Female ,[PHYS.MECA.ACOU] Physics [physics]/Mechanics [physics]/Acoustics [physics.class-ph] ,[SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing ,medicine.drug ,Paper ,Adult ,medicine.medical_specialty ,[SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT] ,[INFO.INFO-TS] Computer Science [cs]/Signal and Image Processing ,[SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine ,[SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine ,03 medical and health sciences ,Fibrinolytic Agents ,Predictive Value of Tests ,[INFO.INFO-IM]Computer Science [cs]/Medical Imaging ,medicine ,Humans ,cardiovascular diseases ,[SPI.SIGNAL] Engineering Sciences [physics]/Signal and Image processing ,Aged ,Cerebral Hemorrhage ,[SPI.ACOU]Engineering Sciences [physics]/Acoustics [physics.class-ph] ,[SDV.IB] Life Sciences [q-bio]/Bioengineering ,[SPI.ACOU] Engineering Sciences [physics]/Acoustics [physics.class-ph] ,[PHYS.PHYS.PHYS-MED-PH] Physics [physics]/Physics [physics]/Medical Physics [physics.med-ph] ,T-plasminogen activator ,business.industry ,[SPI.ELEC] Engineering Sciences [physics]/Electromagnetism ,Magnetic resonance imaging ,medicine.disease ,Surgery ,nervous system diseases ,[SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging ,Diffusion Magnetic Resonance Imaging ,[SPI.OPTI]Engineering Sciences [physics]/Optics / Photonic ,Neurology (clinical) ,Nuclear medicine ,business ,Tomography, X-Ray Computed ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,030217 neurology & neurosurgery ,Fibrinolytic agent - Abstract
Objective: To evaluate clinical, biological, and pretreatment imaging variables for predictors of tissue plasminogen activator (tPA) related intracerebral haemorrhage (ICH) in stroke patients. Methods: 48 consecutive patients with hemispheric stroke were given intravenous tPA within seven hours of symptom onset, after computed tomography (CT) and magnetic resonance imaging (MRI) of the brain. Baseline diffusion weighted (DWI) and perfusion weighted (PWI) imaging volumes, time to peak, mean transit time, regional cerebral blood flow index, and regional cerebral blood volume were evaluated. The distribution of apparent diffusion coefficient (ADC) values was determined within each DWI lesion. Results: The symptomatic ICH rate was 8.3% (four of 48); the rate for any ICH was 43.8% (21 of 48). Univariate analysis showed that age, weight, history of hyperlipidaemia, baseline NIHSS score, glucose level, red blood cell count, and lacunar state on MRI were associated with ICH. However, mean 24 hour systolic blood pressure and a hyperdense artery sign on pretreatment CT were the only independent predictors of ICH. Patients with a hyperdense artery sign had larger pretreatment PWI and DWI lesion volumes and a higher NIHSS score. Analysis of the distribution of ADC values within DWI lesions showed that a greater percentage of pixels had lower ADCs ( −6 mm 2 /s) in patients who experienced ICH than in those who did not. Conclusion: Key clinical and biological variables, pretreatment CT signs, and MRI indices are associated with tPA related intracerebral haemorrhage.
- Published
- 2005