PURPOSE Crossed cerebellar diaschisis (CCD) is a common finding in hyper-acute ischemic stroke, related to supratentorial dysfunction of the contralateral hemisphere. Several studies investigated a possible relationship between CCD and clinical outcomes but still no evidence emerged. We proposed a novel quantitative whole cerebellum analysis using CT perfusion (CTP) imaging to investigate the relationship between CCD and stroke severity, hypoperfused volume and outcome measures. METHODS 55 patients with supratentorial ischemic stroke who underwent CTP evaluation within 4.5 h since symptom onset were enrolled. CCD was evaluated by CTP image-processing and by calculating the mean transit time (MTT)-map asymmetry index in the whole cerebellum. MTT asymmetry correlation with ischemic volume and clinical outcomes was investigated. RESULTS MTT asymmetry was found in most of the included patients and significantly correlated with NIH Stroke Scale (NIHSS) score at baseline and CTP ischemic volume. MTT asymmetry was significantly correlated with hemorrhagic transformation, NIHSS and modified Rankin Scale (mRS) score on discharge in treated patients. CONCLUSIONS CCD was detectable by CTP in acute supratentorial ischemic stroke by processing the whole cerebellum volume. CCD perfusion asymmetry was significantly correlated with neurological and perfusion deficit on admission as well as with clinical outcomes in treated patients.

中文翻译：

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使用 CT 灌注检测急性缺血性卒中交叉小脑分离的新定量方法

目的 交叉小脑神经系统分离 (CCD) 是超急性缺血性卒中的常见表现，与对侧半球幕上功能障碍有关。几项研究调查了 CCD 与临床结果之间可能的关系，但仍然没有证据出现。我们提出了一种使用 CT 灌注 (CTP) 成像的新型定量全小脑分析，以研究 CCD 与中风严重程度、灌注不足量和结果测量之间的关系。方法 55 例幕上缺血性卒中患者在症状出现后 4.5 h 内接受 CTP 评估。通过 CTP 图像处理和计算整个小脑的平均传输时间 (MTT)-map 不对称指数来评估 CCD。研究了 MTT 不对称性与缺血体积和临床结果的相关性。结果 在大多数纳入的患者中发现 MTT 不对称，并且与基线时的 NIH 卒中量表 (NIHSS) 评分和 CTP 缺血体积显着相关。MTT不对称与治疗患者出院时的出血性转化、NIHSS和改良Rankin量表（mRS）评分显着相关。结论 通过处理整个小脑体积，CTP 在急性幕上缺血性卒中中可检测到 CCD。CCD 灌注不对称与入院时的神经和灌注不足以及治疗患者的临床结果显着相关。接受治疗的患者出院时的 NIHSS 和改良 Rankin 量表 (mRS) 评分。结论 通过处理整个小脑体积，CTP 在急性幕上缺血性卒中中可检测到 CCD。CCD 灌注不对称与入院时的神经和灌注不足以及治疗患者的临床结果显着相关。接受治疗的患者出院时的 NIHSS 和改良 Rankin 量表 (mRS) 评分。结论 通过处理整个小脑体积，CTP 在急性幕上缺血性卒中中可检测到 CCD。CCD 灌注不对称与入院时的神经和灌注不足以及治疗患者的临床结果显着相关。