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Related Concept Videos

Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...

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CT Perfusion in Acute Lacunar Stroke: Detection Capabilities Based on Infarct Location.

J C Benson1, S Payabvash2, S Mortazavi2

  • 1From the Department of Radiology (J.C.B., S.P., S.M., A.M.M.) benso905@umn.edu.

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|August 20, 2016
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Summary
This summary is machine-generated.

CTP shows low sensitivity for detecting small lacunar infarcts, especially in the basal ganglia and thalami. However, it offers high specificity, proving useful in specific brain regions.

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Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Recent studies suggest CT Perfusion (CTP) is superior to NCCT/CTA for detecting lacunar infarcts.
  • Lacunar infarcts are small ischemic strokes often challenging to visualize.

Purpose of the Study:

  • To evaluate the capability of CT Perfusion (CTP) in identifying lacunar infarcts across different intracranial regions.
  • To compare CTP performance against Diffusion-Weighted Imaging (DWI) for lacunar infarct detection.

Main Methods:

  • Retrospective review of 1085 CTP examinations in acute stroke patients within 12 hours of symptom onset.
  • Infarct detection and characterization using CTP (CBF, CBV, MTT, TTP) and DWI, with exclusion of larger infarcts.
  • Three blinded reviewers assessed infarcts based on NIHSS scores, symptoms, and imaging findings.

Main Results:

  • Out of 113 patients, 32.7% had lacunar infarcts on DWI.
  • CTP showed low sensitivity (18.9%-48.7%) but high specificity (97.4%-98.7%) for lacunar infarcts.
  • Sensitivity was highest in subcortical white matter (21.7%-65.2%) but 0% in the thalami and basal ganglia.

Conclusions:

  • CTP demonstrates low sensitivity and high specificity for identifying lacunar infarcts.
  • CTP's sensitivity is limited in the basal ganglia and thalami, despite good performance in subcortical white matter.