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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Comparison of Automated CT Perfusion Softwares in Evaluation of Acute Ischemic Stroke
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Comparison of Automated CT Perfusion Softwares in Evaluation of Acute Ischemic Stroke

机译：急性缺血性卒中评估中自动CT灌注软件的比较

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Background and Purpose: Automated imaging software is integral to decision-making in acute ischemic stroke (AIS) during extended time windows. RAPID software is the most widely used and has been validated in landmark endovascular trials. Olea software is another commercially available and FDA-approved software, but has not been studied in AIS trials. We aimed to compare the diagnostic utility and accuracy of RAPID and Olea in everyday clinical practice outside of a clinical trial. Methods: We analyzed prospectively-collected data from a consecutive cohort of 141 patients with suspected AIS who underwent computed tomography perfusion upon presentation followed by diffusion-weighted magnetic resonance imaging (DWI-MRI) within 24-48 hours. Core infarct was defined as the region with a relative cerebral blood flow (rCBF) less than 30% on RAPID and rCBF less than 40% on Olea (default settings). We also evaluated rCBF less than 30% on Olea to match RAPID's default setting. Infarct volume on DWI-MRI was measured using a semi-automated segmentation method. Results: Twenty-one patients were excluded; 14 due to poor bolus tracking and/or motion artifact, and 7 due to software failure. The software failure rate was 4.7% [6/127] with RAPID versus .78% [1/127] with Olea (P = .12). For the remaining 120 patients, the sensitivity and specificity for detecting an acute infarct were 40.5% and 97.6% for RAPID; 50.6% and 85.4% for Olea; and for detecting large infarcts (>= 70 mL on DWI-MRI) 73.7% and 81.2% for RAPID; 73.7% and 68.3% for Olea. Core infarct volume on RAPID was more closely correlated with DWI-MRI infarct volume (rho = .64) than Olea (rho = .42). Conclusions: Our head-to-head comparison of these 2 commonly-used softwares in the clinical setting elucidates the pros and cons of their use to guide decision-making for AIS management in the acute setting.
机译：背景与目的：自动成像软件是不可或缺的决策在延长的时间窗在急性缺血性脑卒中（AIS）。快速的软件是使用最广泛的和标志性血管内试验已经验证。奥莱亚软件是另一种市售的，FDA批准的软件，但一直没有在AIS的试验进行了研究。我们的目的是比较快速的在临床试验中的日常临床实践外的诊断工具和准确性和油橄榄。方法：我们从连续的141名患者的疑似AIS患者分析了预期收集的数据，这些涉嫌AIS在介绍时接受过计算的层析成像灌注，然后在24-48小时内进行扩散加权磁共振成像（DWI-MRI）。芯梗塞定义为区域与相对脑血流量（rCBF）小于30％的RAPID和脑血流量上油橄榄（默认设置）小于40％。我们也评估局部脑血流量小于上油橄榄匹配RAPID的默认设置30％。使用半自动分割方法测量DWI-MRI上的梗塞体积。结果：二十一名患者被排除在外; 14由于较差的推注和/或运动伪影，并且由于软件故障而导致7。软件故障率为4.7％[6/127]，与Olea（p = .12）快速相关.78％[1/127]。对于剩余的120名患者，迅速检测急性梗塞的敏感性和特异性为40.5％和97.6％; 50.6％和油橄榄85.4％;和用于检测大梗塞（> = 70毫升上DWI-MRI）73.7％和RAPID 81.2％; 73.7％和油橄榄68.3％。上RAPID核心梗死体积更紧密地与DWI-MRI梗塞体积（RHO = 0.64）比油橄榄（RHO = 0.42）相关。结论：我们在临床环境中对这2种常用软件的头脑比较阐明了他们使用的利弊，以指导急性环境中的AIS管理决策。

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