BACKGROUND AND PURPOSE: The purpose of this study was to determine whether, in acute stroke patients treated with intra-arterial (IA) recanalization therapy, CT perfusion (CTP) can distinguish ischemic brain tissue destined to infarct from that which will survive. METHODS: Dynamic CTP was obtained in 14 patients within 8 hours of stroke onset, before IA therapy. Initial quantitative cerebral blood volume (CBV) and flow (CBF) values were visually segmented and normalized in the "infarct core" (region 1: reduced CBV and CBF, infarction on follow-up), "penumbra that infarcts" (region 2: normal CBV, reduced CBF, infarction on follow-up), and "penumbra that recovers" (region 3: normal CBV, reduced CBF, normal on follow-up). Normalization was accomplished by dividing the ischemic region of interest value by that of a corresponding, contralateral, uninvolved region, which resulted in CBV and CBF "ratios." Separate CBV and CBF values were obtained in gray matter (GM) and white matter (WM). RESULTS: Mean CBF ratios for regions 1, 2, and 3 were 0.19 +/- 0.06, 0.34 +/- 0.06, and 0.46 +/- 0.09, respectively (all P < .001). Mean CBV ratios for regions 1, 2, and 3 were similarly distinct (all P < .05). Absolute CBV and CBF values for regions 2 and 3 were not significantly different. All regions with CBF ratio <0.32, CBV ratio <0.68, CBF <12.7 mL/100 g/min, or CBV <2.2 mL/100 g infarcted. No region with CBF ratio >0.44 infarcted. GM versus WM CBF and CBV values were significantly different for region 2 compared with region 3 (P < .05). CONCLUSIONS: In acute stroke patients, quantitative CTP can distinguish ischemic tissue likely to infarct from that likely to survive.
BACKGROUND AND PURPOSE: The purpose of this study was to determine whether, in acute strokepatients treated with intra-arterial (IA) recanalization therapy, CT perfusion (CTP) can distinguish ischemic brain tissue destined to infarct from that which will survive. METHODS: Dynamic CTP was obtained in 14 patients within 8 hours of stroke onset, before IA therapy. Initial quantitative cerebral blood volume (CBV) and flow (CBF) values were visually segmented and normalized in the "infarct core" (region 1: reduced CBV and CBF, infarction on follow-up), "penumbra that infarcts" (region 2: normal CBV, reduced CBF, infarction on follow-up), and "penumbra that recovers" (region 3: normal CBV, reduced CBF, normal on follow-up). Normalization was accomplished by dividing the ischemic region of interest value by that of a corresponding, contralateral, uninvolved region, which resulted in CBV and CBF "ratios." Separate CBV and CBF values were obtained in gray matter (GM) and white matter (WM). RESULTS: Mean CBF ratios for regions 1, 2, and 3 were 0.19 +/- 0.06, 0.34 +/- 0.06, and 0.46 +/- 0.09, respectively (all P < .001). Mean CBV ratios for regions 1, 2, and 3 were similarly distinct (all P < .05). Absolute CBV and CBF values for regions 2 and 3 were not significantly different. All regions with CBF ratio <0.32, CBV ratio <0.68, CBF <12.7 mL/100 g/min, or CBV <2.2 mL/100 g infarcted. No region with CBF ratio >0.44 infarcted. GM versus WM CBF and CBV values were significantly different for region 2 compared with region 3 (P < .05). CONCLUSIONS: In acute strokepatients, quantitative CTP can distinguish ischemic tissue likely to infarct from that likely to survive.
Authors: M H Lev; A Z Segal; J Farkas; S T Hossain; C Putman; G J Hunter; R Budzik; G J Harris; F S Buonanno; M A Ezzeddine; Y Chang; W J Koroshetz; R G Gonzalez; L H Schwamm Journal: Stroke Date: 2001-09 Impact factor: 7.914
Authors: Max Wintermark; Marc Reichhart; Jean-Philippe Thiran; Philippe Maeder; Marc Chalaron; Pierre Schnyder; Julien Bogousslavsky; Reto Meuli Journal: Ann Neurol Date: 2002-04 Impact factor: 10.422
Authors: A G Sorensen; F S Buonanno; R G Gonzalez; L H Schwamm; M H Lev; F R Huang-Hellinger; T G Reese; R M Weisskoff; T L Davis; N Suwanwela; U Can; J A Moreira; W A Copen; R B Look; S P Finklestein; B R Rosen; W J Koroshetz Journal: Radiology Date: 1996-05 Impact factor: 11.105
Authors: Pamela W Schaefer; Yelda Ozsunar; Julian He; Leena M Hamberg; George J Hunter; A Gregory Sorensen; Walter J Koroshetz; R Gilberto Gonzalez Journal: AJNR Am J Neuroradiol Date: 2003-03 Impact factor: 3.825
Authors: Edward D Greenberg; Y Pierre Gobin; Howard Riina; Carl E Johnson; Apostolos J Tsiouris; Joseph Comunale; Pina C Sanelli Journal: Imaging Med Date: 2011-06-01
Authors: M Matsumoto; N Kodama; Y Endo; J Sakuma; Ky Suzuki; T Sasaki; K Murakami; Ke Suzuki; T Katakura; F Shishido Journal: AJNR Am J Neuroradiol Date: 2007-02 Impact factor: 3.825
Authors: Seyedmehdi Payabvash; Leticia C S Souza; Yifei Wang; Pamela W Schaefer; Karen L Furie; Elkan F Halpern; R Gilberto Gonzalez; Michael H Lev Journal: Stroke Date: 2011-04-14 Impact factor: 7.914
Authors: T Bley; C M Strother; K Pulfer; K Royalty; M Zellerhoff; Y Deuerling-Zheng; F Bender; D Consigny; R Yasuda; D Niemann Journal: AJNR Am J Neuroradiol Date: 2010-01-06 Impact factor: 3.825