Early CT perfusion mismatch in XXXX is not time-dependent but relies on collateralization grade.

@entity1 @entity64 @entity2500 @entity93 @entity1188 @entity3554
INTRODUCTION: Factors that determine the extent of the penumbra in the initial diagnostic workup using whole brain CT Perfusion (WB-CTP) remain unclear. The purpose of the current study was to determine a possible dependency of the initial mismatch size between cerebral blood flow (CBF) and cerebral blood volume (CBV) from time after symptom onset, @entity3554 , and occlusion localization in acute @entity2500 . METHODS: Out of an existing cohort of 992 consecutive @entity1 receiving multiparametric CT scans including WB-CTP due to suspected @entity64 , we included @entity1 who had (1) a witnessed time of symptom onset, (2) an @entity1188 of the MCA territory as documented by follow-up imaging, and (3) an initial CBF volume of >10  ml. CBF and CBV lesion sizes, collateralization grade, and the site of occlusion were determined. RESULTS: We included 103 @entity1 . Univariate analysis showed that time from symptom  onset (168   +/-   91.2  min) did not correlate with relative or absolute mismatch volumes (p   =   0.458 and p   =   0.921). Higher collateralization gradings were associated with small absolute mismatch volumes (p   =   0.004 and p   <   0.001). Internal carotid artery (ICA) occlusions were associated with large absolute mismatch volumes (p   =   0.004). Multivariate analysis confirmed that ICA occlusion was associated with large absolute mismatch volumes (p   =   0.005), and high collateral grade was associated with small absolute mismatch volumes (p   =   0.017). CONCLUSIONS: There is no significant correlation between initial @entity93 mismatch and time after symptom onset. Predictors of mismatch size include the extent of the collaterals and a proximal location of the occlusion.
