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Master Thesis

Prédiction du risque de transformation hémorragique, à la phase aiguë d’un infarctus cérébral : apport du scanner de perfusion

Abstract : The occurrence of a haemorrhagic transformation is a potentially severe complication of stroke, which can be aggravated by thrombolysis. Several risk factors of the haemorrhagic transformation have been reported within the literature but the contribution of advanced imaging methods frequently used in the acute phase of stroke, such as the perfusion CT, is still uncertain. Objective: Determining the contribution of CT perfusion for the early prediction of the haemorrhagic transformation risk in the acute phase of a stroke. Methods: We report a cohort analysis with case-control study, from patients in the acute phase of stroke, who underwent a CT perfusion, and constituted a supratentoriel ischemic stroke proven on MRI. The imaging analysis was run with OLEA sphere® software using the Bayesian deconvolution method based on the Cerebral Blood Flow (CBF), Cerebral Blood Volume (CBV), Mean Transit Time (MTT), Time To Peak (TTP), and Delay of the ischemic zone, and in the haemorrhagic zone for the bleeding group. Clinical and biological factors analyses were performed in parallel on the studied population. Results: Data from 149 patients were included, 56 from the “haemorrhagic transformation” group and 93 from the “without” group. Temporal parameters of the CT perfusion, being MTT, TTP and Delay (p<0,05), were found significantly associated with the haemorrhagic risk in the univariate analysis but not in the multivariate analysis. Conclusion: The CT perfusion study on the acute phase of a stroke did not demonstrate predictive factors for the haemorrhagic transformation. Increased numbers of patients and development of new imaging analysis methods are needed to confirm tendencies concerning temporal parameters.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01228490
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, November 13, 2015 - 11:23:49 AM
Last modification on : Wednesday, August 23, 2017 - 4:40:39 PM
Long-term archiving on: : Friday, April 28, 2017 - 2:57:48 PM

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Thomas Mégelin. Prédiction du risque de transformation hémorragique, à la phase aiguë d’un infarctus cérébral : apport du scanner de perfusion. Médecine humaine et pathologie. 2015. ⟨dumas-01228490⟩

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