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|November 6, 2010

Summary

CT angiography with iodine concentration (CTA-SI) in stroke patients is weighted by cerebral blood flow (CBF), not cerebral blood volume (CBV). This finding impacts how stroke imaging is interpreted.

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Area of Science:

Neuroimaging
Radiology
Stroke Imaging

Background:

Cerebral blood volume (CBV) has been the assumed correlate of CT angiography with iodine concentration (CTA-SI).
Modern multisection CT scanners may alter the weighting of CTA-SI.

Purpose of the Study:

To investigate whether CTA-SI performed with modern CT scanners reflects cerebral blood flow (CBF) or CBV.
To compare the correlation of CTA-SI with CBF and CBV.

Main Methods:

Sixty-four anterior circulation stroke patients were analyzed.
Defect volumes from CTA-SI, perfusion CT (PCCT), CBF, and CBV images were calculated by blinded readers.
Spearman correlation and linear regression were used to analyze lesion volumes and identify outliers.

Main Results:

CTA-SI showed a strong positive correlation with CBF (r = 0.89, P < .0001).
CTA-SI had a weaker correlation with CBV (r = 0.5, P < .0001).
Perfusion CT (PCCT) correlated strongly with CBV (r = 0.79, P < .0001) and less strongly with CBF (r = 0.52, P < .0001).

Conclusions:

CTA-SI is predominantly CBF-weighted, not CBV-weighted.
This suggests a shift in understanding CTA-SI's role in stroke assessment.