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Related Experiment Video

Updated: Dec 29, 2025

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Infarct Core Reliability by CT Perfusion is a Time-Dependent Phenomenon.

Sivan-Hoffmann Rotem1,2, Saban Mor3, Buxbaum Chen4

  • 1Department of Radiology, Rambam Health Care Campus, Haifa, Israel.

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|February 11, 2020
PubMed
Summary

Computed tomography perfusion (CTP) may overestimate infarct core in acute stroke patients receiving endovascular treatment (EVT). This overestimation is time-dependent, with results from early arrivals needing cautious interpretation.

Keywords:
Acute ischemic strokecerebral blood flowcerebral blood volume computed tomography perfusionghost infarct core

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Computed tomography perfusion (CTP) is crucial for selecting acute stroke patients for endovascular treatment (EVT) within extended time windows.
  • Concerns exist regarding potential overestimation of the initial ischemic core by CTP, particularly related to stroke onset time.

Purpose of the Study:

  • To identify predictors of infarct core overestimation by CTP in patients undergoing EVT.
  • To evaluate the relationship between time from stroke onset to CTP and infarct core overestimation.

Main Methods:

  • Retrospective analysis of 31 acute stroke patients who underwent EVT and CTP with successful recanalization.
  • Infarct core volume was measured on CTP and final infarct volume on follow-up CT at 24 hours.
  • Overestimation was defined as an initial core-final infarct difference >10 mL.

Main Results:

  • Seventeen of 31 eligible patients (55%) showed infarct core overestimation.
  • Logistic regression identified time from symptom onset to CTP as an inverse predictor of overestimation.
  • A cutoff time of 170 minutes demonstrated 94% sensitivity and 43% specificity for predicting overestimation.

Conclusions:

  • Overestimation of the infarct core by CTP in EVT patients is significantly influenced by the time elapsed since stroke onset.
  • CTP findings in patients arriving early after symptom onset should be interpreted with caution due to potential overestimation.