Multiphasic perfusion computed tomography in hyperacute ischemic stroke: comparison with diffusion and perfusion...

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Hyperacute ischemic stroke requires accurate prognostication for treatment decisions.
• Assessing final infarct volume, infarct growth, and clinical severity is crucial in untreated stroke patients.
• Advanced imaging techniques like CT and MRI play a vital role in stroke evaluation.

Purpose of the Study:

• To compare multiphasic perfusion computed tomography (CT) with diffusion and perfusion magnetic resonance imaging (MRI).
• To evaluate the predictive capabilities of these imaging modalities for final infarct volume, infarct growth, and clinical severity.
• To assess their utility in patients with hyperacute ischemia not treated with thrombolytic therapy.

Main Methods:

• 19 patients with ischemic stroke within 6 hours of symptom onset underwent multiphasic perfusion CT.
• CT-derived peak and total perfusion maps were generated.
• Diffusion-weighted imaging (DWI) and perfusion MRI were acquired post-CT for comparison.

Main Results:

• CT perfusion map lesion volumes strongly correlated with MRI measures of cerebral blood volume and flow.
• CT peak perfusion and MRI rCBF were similarly predictive of final infarct volume and clinical scores.
• CT or DWI mismatch was a better predictor of infarct growth than other mismatch parameters.

Conclusions:

• Multiphasic perfusion CT demonstrates utility comparable to diffusion and perfusion MRI.
• CT perfusion imaging is valuable for predicting outcomes in acute ischemic stroke.
• This technique aids in assessing infarct progression and clinical severity in stroke patients.