BACKGROUND AND PURPOSE: Because cerebral perfusion imaging for acute stroke is unavailable in most hospitals, we investigated the feasibility of a method of perfusion scanning that can be performed rapidly during standard cranial CT. Our aim was to identify the scanning parameters best suited to indicate tissue at risk and to measure a perfusion limit to predict infarction. METHODS: Seventy patients who had suffered stroke and had undergone cranial CT 0.5 to 12 hours (median, 3.75 hr) after the onset of symptoms participated in the study. While undergoing conventional CT, each patient received a bolus of iodinated contrast medium. Maps of time to peak (TTP), cerebral blood volume (CBV), and CBF were calculated from the resulting dynamically enhanced scans. These perfusion images were compared with follow-up CT scans or MR images showing the final infarctions. RESULTS: CBF maps predicted the extent of cerebral infarction with a sensitivity of 93% and a specificity of 98%. In contrast, CBV maps were less sensitive and TTP maps were less specific and also showed areas of collateral flow. Infarction occurred in all of the patients with CBF reduction of more than 70% and in half of the patients with CBF reduction of 40% to 70%. CONCLUSION: Dynamic CT perfusion imaging safely detects tissue at risk in cases of acute stroke and is a feasible method for any clinic with a third-generation CT scanner.
BACKGROUND AND PURPOSE: Because cerebral perfusion imaging for acute stroke is unavailable in most hospitals, we investigated the feasibility of a method of perfusion scanning that can be performed rapidly during standard cranial CT. Our aim was to identify the scanning parameters best suited to indicate tissue at risk and to measure a perfusion limit to predict infarction. METHODS: Seventy patients who had suffered stroke and had undergone cranial CT 0.5 to 12 hours (median, 3.75 hr) after the onset of symptoms participated in the study. While undergoing conventional CT, each patient received a bolus of iodinated contrast medium. Maps of time to peak (TTP), cerebral blood volume (CBV), and CBF were calculated from the resulting dynamically enhanced scans. These perfusion images were compared with follow-up CT scans or MR images showing the final infarctions. RESULTS:CBF maps predicted the extent of cerebral infarction with a sensitivity of 93% and a specificity of 98%. In contrast, CBV maps were less sensitive and TTP maps were less specific and also showed areas of collateral flow. Infarction occurred in all of the patients with CBF reduction of more than 70% and in half of the patients with CBF reduction of 40% to 70%. CONCLUSION: Dynamic CT perfusion imaging safely detects tissue at risk in cases of acute stroke and is a feasible method for any clinic with a third-generation CT scanner.
Authors: G Rordorf; W J Koroshetz; W A Copen; S C Cramer; P W Schaefer; R F Budzik; L H Schwamm; F Buonanno; A G Sorensen; G Gonzalez Journal: Stroke Date: 1998-05 Impact factor: 7.914
Authors: W Hacke; M Kaste; C Fieschi; R von Kummer; A Davalos; D Meier; V Larrue; E Bluhmki; S Davis; G Donnan; D Schneider; E Diez-Tejedor; P Trouillas Journal: Lancet Date: 1998-10-17 Impact factor: 79.321
Authors: W Hacke; M Kaste; C Fieschi; D Toni; E Lesaffre; R von Kummer; G Boysen; E Bluhmki; G Höxter; M H Mahagne Journal: JAMA Date: 1995-10-04 Impact factor: 56.272
Authors: H C Roberts; T P Roberts; W S Smith; T J Lee; N J Fischbein; W P Dillon Journal: AJNR Am J Neuroradiol Date: 2001 Jun-Jul Impact factor: 3.825
Authors: R Handschu; S Fateh-Moghadam; E Klotz; A Schmid; B Stemper; J G Heckmann; W J Huk; B Neundörfer; B F Tomandl Journal: Nervenarzt Date: 2004-06 Impact factor: 1.214
Authors: Branko N Huisa; William P Neil; Ronald Schrader; Marcel Maya; Benedict Pereira; Nhu T Bruce; Patrick D Lyden Journal: J Stroke Cerebrovasc Dis Date: 2012-12-14 Impact factor: 2.136