{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:45:07Z","timestamp":1777945507229,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to assess the performance of time to maximum concentration (Tmax) using computed tomography perfusion for predicting stroke recurrence in patients with symptomatic non-acute atherosclerotic middle cerebral artery occlusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective monocentric study enrolled 138 patients diagnosed with non-acute atherosclerotic middle cerebral artery occlusion. In addition to conventional computed tomography angiography or digital subtraction angiography, all patients underwent head computed tomography perfusion and magnetic resonance imaging 7\u201314 days after stroke and repeat head magnetic resonance imaging at 3\u20136 weeks. Volume of time to maximum concentration &gt;4\u2009s was considered the hypoperfusion area. The association between imaging characteristics, new ischemic lesion or lesion size increase on magnetic resonance imaging, and patient prognosis was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Increased number\/area of infarct lesion was observed in 52\/138 (37.7%) patients on diffusion weighted imaging 3\u20136 weeks after the first stroke. The volume of time to maximum concentration\u2009&gt;4\u2009s at baseline was strongly associated with infarct lesion development (odds ratio\u2009=\u20091.22 per 10-mL increase, 95% confidence interval: 1.10\u20131.34,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Volume of time to maximum concentration &gt;4\u2009s exhibited high discriminative ability for poor prognosis (area under the curve\u2009=\u20090.84, 95% confidence interval: 0.78\u20130.91,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) with volume of time to maximum concentration &gt;4\u2009s larger than 99.8\u2009mL being an optimal cutoff (odds ratio\u2009=\u200914.31, 95% confidence interval: 5.84\u201340.89,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001, sensitivity\u2009=\u20090.88 and specificity\u2009=\u20090.65).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The risk of stroke recurrence in patients with symptomatic non-acute atherosclerotic middle cerebral artery occlusion gradually increases with the volume of time to maximum concentration &gt;4\u2009s. Patients with volume of time to maximum concentration &gt;4\u2009s larger than 99.8\u2009mL may have a significantly higher risk of stroke. Volume of time to maximum concentration &gt;4\u2009s on computed tomography perfusion can be used to predict the prognosis in patients with symptomatic non-acute atherosclerotic middle cerebral artery occlusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261443080","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T01:32:50Z","timestamp":1777512770000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prediction of recurrence in patients with non-acute atherosclerotic middle cerebral artery occlusion: A longitudinal study using computed tomography perfusion and magnetic resonance imaging"],"prefix":"10.1177","volume":"54","author":[{"given":"Xi","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rongcheng","family":"Zou","sequence":"additional","affiliation":[{"name":"Nanjing Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"He","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangxin","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhibin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9506-5314","authenticated-orcid":false,"given":"Yun","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, China"},{"name":"Nanjing Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5341-2776","authenticated-orcid":false,"given":"Jingwei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, China"},{"name":"Nanjing Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411587"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414792"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414905"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503780"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1415061"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1706442"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713973"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.505776"},{"key":"e_1_3_6_10_2","first-page":"CD010722","article-title":"Transcranial Doppler sonography for detecting stenosis or occlusion of intracranial arteries in people with acute ischaemic stroke","volume":"2","author":"Mattioni A","year":"2020","unstructured":"Mattioni A, Cenciarelli S, Eusebi P, et\u00a0al. 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