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Dynamic CT perfusion imaging of acute stroke
T E Mayer1, G F Hamann, J Baranczyk
1Department of Neuroradiology, Ludwig-Maximilians University, Munich, Germany.
AJNR. American Journal of Neuroradiology
|September 26, 2000
Summary
Dynamic CT perfusion imaging accurately identifies acute stroke tissue at risk. Cerebral blood flow (CBF) maps effectively predict final infarct extent, proving this rapid method feasible for widespread clinical use.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Cerebral perfusion imaging for acute stroke is not widely available.
- Standard cranial CT is common in hospitals.
Purpose of the Study:
- Investigate the feasibility of rapid perfusion scanning during standard cranial CT.
- Identify optimal parameters for indicating tissue at risk.
- Measure a perfusion limit to predict infarction.
Main Methods:
- Seventy stroke patients underwent cranial CT 0.5-12 hours post-symptom onset.
- Iodinated contrast medium was administered during conventional CT.
- Dynamic scans generated maps of time to peak (TTP), cerebral blood volume (CBV), and cerebral blood flow (CBF).
Main Results:
- Cerebral blood flow (CBF) maps showed 93% sensitivity and 98% specificity in predicting cerebral infarction extent.
- CBF reduction >70% indicated infarction in all patients.
- CBV maps were less sensitive; TTP maps were less specific.
Conclusions:
- Dynamic CT perfusion imaging safely detects tissue at risk in acute stroke.
- This method is feasible for clinics with third-generation CT scanners.