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Related Experiment Videos

Visualization of ischaemic penumbra using a computed tomography perfusion method.

R T F Cheung1, Pui W Cheng, Wai M Lui

  • 1University Department of Medicine, Queen Mary Hospital, Hong Kong. rtcheung@hkucc.hku.hk

Cerebrovascular Diseases (Basel, Switzerland)
|March 21, 2003
PubMed
Summary

Computed tomography (CT) perfusion imaging visualized the ischemic penumbra in a stroke patient. CT perfusion may also explain bleeding after decompressive surgery for stroke.

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Assessing acute ischemic stroke requires accurate imaging to differentiate infarct core from penumbra.
  • Computed tomography (CT) perfusion and magnetic resonance imaging (MRI) are advanced neuroimaging techniques used for stroke evaluation.

Observation:

  • A 51-year-old male patient with left middle cerebral artery infarction underwent CT perfusion and diffusion/perfusion MRI at 15 and 15.5 hours post-onset, respectively.
  • Diffusion-weighted MRI identified the established infarct, which showed low cerebral blood flow (CBF) and cerebral blood volume (CBV) on CT perfusion.
  • The ischemic penumbra, visualized as a perfusion-diffusion mismatch on MRI, exhibited reduced CBF, prolonged mean transit time (MTT), and compensated CBV on CT perfusion.

Findings:

  • CT perfusion imaging successfully visualized the ischemic penumbra by demonstrating reduced CBF and prolonged MTT.

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  • The established infarct core correlated with low CBF and CBV values on CT perfusion.
  • Spontaneous bleeding occurred in the left lentiform nucleus post-decompressive craniectomy, a site potentially identifiable by CT perfusion parameters.

    • Implications:

    • CT perfusion parameters (CBF, CBV, MTT) can help identify the ischemic penumbra in acute stroke.
    • CT perfusion may aid in predicting the risk and location of hemorrhagic transformation after decompressive surgery for stroke.
    • These findings highlight the complementary roles of CT perfusion and MRI in acute stroke management and surgical planning.