Brain perfusion-CT in acute stroke patients.
1Department of Radiology, University of California San Francisco (UCSF), 505 Parnassus Avenue, Box 0628, San Francisco, CA 94143, USA. Max.Wintermark@radiology.ucsf.edu
European Radiology
|February 16, 2006
Summary
Modern CT scans, including CT angiography and perfusion CT, now guide acute stroke treatment by identifying tissue at risk and guiding reperfusion therapy, improving patient outcomes.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Neuroimaging's role in acute stroke evaluation has evolved from solely anatomical assessment to include physiological information.
- The advent of thrombolysis necessitates imaging that identifies patients who may benefit from therapy, particularly the ischemic penumbra.
Purpose of the Study:
- To highlight the advancements in CT imaging for hyperacute stroke evaluation.
- To emphasize the combined utility of CT angiography (CTA) and perfusion CT (PCT) in acute stroke management.
Main Methods:
- Utilizing a modern CT survey comprising noncontrast CT (NCT), perfusion CT (PCT), and CT angiography (CTA).
- CTA for assessing arterial anatomy, occlusion site, collateral flow, and atherosclerotic disease.
- PCT for accurately delineating infarct core and ischemic penumbra (tissue at risk).
Main Results:
- Modern CT protocols (NCT, PCT, CTA) meet the requirements for hyperacute stroke imaging.
- CTA effectively identifies occlusion sites, arterial dissection, collateral status, and atherosclerotic disease.
- PCT precisely delineates the infarct core and the ischemic penumbra.
Conclusions:
- CT imaging, particularly PCT and CTA, provides crucial physiological and anatomical information for acute stroke assessment.
- The integration of PCT and CTA enables individualized reperfusion strategies, expanding eligibility for thrombolytic therapy.
- CT's wide availability makes it a practical choice for advanced acute stroke imaging and treatment guidance.
