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Related Experiment Videos

Evaluation of hyperacute stroke using perfusion computed tomography.

Yasuhiro Suzuki1, Masateru Nakajima, Hisato Ikeda

  • 1Department of Neurosurgery, Showa University School of Medicine. yasu-suzuki-sn@ikegamihosp.jp

Neurologia Medico-Chirurgica
|July 26, 2005
PubMed
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Perfusion CT effectively identifies early stroke, aiding treatment planning. Mean transit time maps show promise, especially for carotid system ischemia, with established ratios for identifying infarct boundaries.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Early detection of cerebral circulation dynamics is crucial for stroke treatment.
  • Initial CT scans may not reveal ischemic changes in acute stroke.
  • Perfusion CT offers a method to assess blood flow and volume in the brain.

Purpose of the Study:

  • To evaluate the effectiveness of perfusion CT in identifying early ischemic changes in stroke patients.
  • To determine the diagnostic accuracy of perfusion CT parameters like MTT, CBF, and CBV.
  • To establish thresholds for perfusion CT ratios indicative of ischemia.

Main Methods:

  • 118 stroke patients within 10 hours of onset underwent perfusion CT.
  • Mean transit time (MTT), cerebral blood flow (CBF), and cerebral blood volume (CBV) maps were analyzed.

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  • Ratios of perfusion parameters in ischemic regions versus contralateral hemispheres were calculated and compared with angiography and MR imaging.

    • Main Results:

    • MTT maps correctly identified a significant proportion of carotid system ischemia (44/46) and some vertebrobasilar (20/29) and perforator (11/35) ischemia.
    • Established ratios for the boundaries of ischemia: rCBF of 0.5 and rCBV of 0.9.
    • Perfusion CT MTT maps showed good correlation with angiography for the carotid system but less so for other systems.

    Conclusions:

    • Perfusion CT, particularly MTT mapping, is valuable for detecting early ischemic changes in stroke patients.
    • The established rCBF and rCBV ratios can aid in defining ischemic boundaries.
    • Further refinement may be needed for perfusion CT accuracy in vertebrobasilar and perforator ischemia detection.