Xiaoling Wu1,2, Yuelong Yang1, Menghuang Wen1, Lijuan Wang3, Yunjun Yang1, Yuhu Zhang3, Zihua Mo1, Kun Nie3, Biao Huang4. 1. Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China. 2. School of Medicine, South China University of Technology, Guangzhou, 510006, China. 3. Department of Neurology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China. 4. Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China. huangbiao@gdph.org.cn.
Abstract
PURPOSE: Computed tomography (CT) perfusion (CTP) source images contain both brain perfusion and cerebrovascular information, and may allow a dynamic assessment of collaterals. The purpose of the study was to compare the image quality and the collaterals identified on multiphase CT angiography (CTA) derived from CTP datasets (hereafter called CTPA) reconstructed with iterative model reconstruction (IMR) algorithm in patients with middle cerebral artery (MCA) steno-occlusion with those of routine CTA. METHODS: Consecutive patients with a unilateral MCA steno-occlusion underwent non-contrast CT (NCCT), CTP, and CTA. CTPA images were reconstructed from CTP datasets. The vascular attenuation, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of routine CTA and CTPA were measured and analyzed by Student's t test. Subjective image quality and collaterals were scored and compared using the Wilcoxon signed-rank test. RESULTS: Fifty-eight patients (mean age 61.7 years, 78% males, median National Institutes of Health Stroke Scale score = 12) were included. The effective radiation dose of CTP was 1.28 mSv. The vascular attenuation, SNR, CNR, and the image quality of CTPA were considerably higher than that of CTA (all, p < 0.001). Collaterals were rated higher on CTPA compared with CTA (1.79 ± 0.64 vs. 1.22 ± 0.84, p < 0.001). Fifty-three percent of patients with poor collaterals assessed on single-phase CTA had good collaterals on CTPA. CONCLUSION: CTPA derived from CTP datasets reconstructed with IMR algorithm offers image quality comparable to routine CTA and provides time-resolved evaluation of collaterals in patients with MCA ischemic disease.
PURPOSE: Computed tomography (CT) perfusion (CTP) source images contain both brain perfusion and cerebrovascular information, and may allow a dynamic assessment of collaterals. The purpose of the study was to compare the image quality and the collaterals identified on multiphase CT angiography (CTA) derived from CTP datasets (hereafter called CTPA) reconstructed with iterative model reconstruction (IMR) algorithm in patients with middle cerebral artery (MCA) steno-occlusion with those of routine CTA. METHODS: Consecutive patients with a unilateral MCA steno-occlusion underwent non-contrast CT (NCCT), CTP, and CTA. CTPA images were reconstructed from CTP datasets. The vascular attenuation, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of routine CTA and CTPA were measured and analyzed by Student's t test. Subjective image quality and collaterals were scored and compared using the Wilcoxon signed-rank test. RESULTS: Fifty-eight patients (mean age 61.7 years, 78% males, median National Institutes of Health Stroke Scale score = 12) were included. The effective radiation dose of CTP was 1.28 mSv. The vascular attenuation, SNR, CNR, and the image quality of CTPA were considerably higher than that of CTA (all, p < 0.001). Collaterals were rated higher on CTPA compared with CTA (1.79 ± 0.64 vs. 1.22 ± 0.84, p < 0.001). Fifty-three percent of patients with poor collaterals assessed on single-phase CTA had good collaterals on CTPA. CONCLUSION:CTPA derived from CTP datasets reconstructed with IMR algorithm offers image quality comparable to routine CTA and provides time-resolved evaluation of collaterals in patients with MCA ischemic disease.
Authors: Ewoud J Smit; Evert-jan Vonken; Tom van Seeters; Jan Willem Dankbaar; Irene C van der Schaaf; L Jaap Kappelle; Bram van Ginneken; Birgitta K Velthuis; Mathias Prokop Journal: Stroke Date: 2013-06-11 Impact factor: 7.914
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Authors: Max Wintermark; Gregory W Albers; Andrei V Alexandrov; Jeffry R Alger; Roland Bammer; Jean-Claude Baron; Stephen Davis; Bart M Demaerschalk; Colin P Derdeyn; Geoffrey A Donnan; James D Eastwood; Jochen B Fiebach; Marc Fisher; Karen L Furie; Gregory V Goldmakher; Werner Hacke; Chelsea S Kidwell; Stephan P Kloska; Martin Köhrmann; Walter Koroshetz; Ting-Yim Lee; Kennedy R Lees; Michael H Lev; David S Liebeskind; Leif Ostergaard; William J Powers; James Provenzale; Peter Schellinger; Robert Silbergleit; Alma Gregory Sorensen; Joanna Wardlaw; Ona Wu; Steven Warach Journal: AJNR Am J Neuroradiol Date: 2008-05 Impact factor: 3.825