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    Absent Contrast Filling of Ipsilateral Superficial Middle Cerebral Vein Predicts Midline Shift in Acute Middle Cerebral Artery Occlusion.

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    Author
    Zhang, S; Lin, L; Zhang, R; Wang, M; Yu, Y; Shi, Z; Parsons, M; Geng, Y
    Date
    2020
    Source Title
    Frontiers in Neurology
    Publisher
    Frontiers Media SA
    University of Melbourne Author/s
    Parsons, Mark
    Affiliation
    Medicine and Radiology
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Zhang, S., Lin, L., Zhang, R., Wang, M., Yu, Y., Shi, Z., Parsons, M. & Geng, Y. (2020). Absent Contrast Filling of Ipsilateral Superficial Middle Cerebral Vein Predicts Midline Shift in Acute Middle Cerebral Artery Occlusion.. Front Neurol, 11, pp.570844-. https://doi.org/10.3389/fneur.2020.570844.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/253042
    DOI
    10.3389/fneur.2020.570844
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674643
    Abstract
    Background and purpose: Midline shift is a life-threatening complication of acute large artery occlusion (LAO). The value of superficial middle cerebral vein (SMCV) for predicting midline shift is currently unclear for patients with acute LAO. Methods: Consecutive acute LAO (middle cerebral artery M1 ± intracranial internal carotid artery) patients between March 2018 and May 2019 were included. Absent filling of ipsilateral cortical vein (marked as SMCV-) was defined as no contrast filling into the vein across the whole venous phase of four-dimensional computed tomography (CT) angiography derived from CT perfusion in the ischemic hemisphere. Results: In the total of 81 patients, 31 (38.4%) were identified as SMCV-. SMCV- independently predicted midline shift, with sensitivity of 87.5% and specificity of 82.5%. Receiver operating characteristic analysis showed that including SMCV- as a predictor in addition to baseline ischemic core volume significantly increased the area under the curve in predicting midline shift (SMCV- with baseline ischemic core volume vs. baseline ischemic core volume: AUC = 0.903 vs. 0.841, Z = 2.451, P = 0.014). Conclusion: In acute LAO patients, the presence of SMCV- was a sensitive and specific imaging marker for midline shift. SMCV- had supplementary value to baseline ischemic core volume in predicting midline shift.

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