Perfusion CT: Additional Diagnostic and Clinical Information in MCA Stroke

Area of Science:

• Neuroradiology
• Neurology
• Medical Imaging

Background:

• Early detection of ischemic stroke is crucial for effective treatment.
• Non-enhanced CT (NECT) and perfusion CT (PCT) offer insights into brain ischemia.
• Differentiating between reversible and irreversible brain damage guides therapeutic choices.

Purpose of the Study:

• To evaluate the sensitivity of NECT and PCT in diagnosing middle cerebral artery (MCA) ischemic stroke.
• To correlate imaging findings with clinical severity and patient outcomes.
• To analyze changes in imaging markers over time.

Main Methods:

• Thirty patients with MCA ischemic stroke underwent NECT and PCT in acute, subacute, and chronic phases.
• Clinical assessment and outcome were evaluated using the modified National Institute of Health Stroke Scale (mNIHSS).
• Analysis included sensitivity, correlation with clinical data, and temporal changes of imaging parameters.

Main Results:

• PCT demonstrated higher sensitivity (83%) than NECT (70%) in diagnosing MCA stroke.
• Mean transit time (MTT) and cerebral ischemic volume (CIV) correlated with clinical severity on admission.
• Initial NECT changes correlated with clinical evolution in subacute and chronic phases.

Conclusions:

• The combination of NECT and PCT enables early stroke diagnosis and may predict clinical severity and outcome.
• This combined approach provides insights into the penumbra and quantifies the potential recuperation ratio (PRR), crucial for therapeutic decision-making.