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CT vascular territory mapping: a novel method to identify large vessel occlusion collateral
Michael Valente1, Andrew Bivard2, Andrew Cheung3,4,5,6
1Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia. michael.valente@mh.org.au.
Neuroradiology
|August 10, 2022
Summary
Vascular territory mapping (VTM) using CT perfusion in ischemic stroke patients with proximal vessel occlusion reveals an increase in collateral vessel territories. This novel technique aids in identifying the source and extent of collateral blood flow.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Ischemic stroke with proximal vessel occlusion requires assessment of collateral blood flow.
- Vascular territory mapping (VTM) is a novel CT perfusion technique.
- VTM identifies the source and extent of collateral circulation by determining dominant blood supply to brain voxels.
Purpose of the Study:
- To explore typical vascular territory mapping (VTM) patterns in ischemic stroke patients.
- To analyze VTM in the context of common large vessel occlusion sites (anterior cerebral artery/middle cerebral artery/posterior cerebral artery).
Main Methods:
- Descriptive study analyzing 167 consecutive patients from the INSPIRE registry.
- CT perfusion data were reprocessed using VTM software.
- Exploration of territory maps generated by VTM software for specific occlusion locations.
Main Results:
- VTM demonstrated characteristic patterns in patients with proximal vessel occlusion.
- A reciprocal increase in collateral vessel territories was observed in the presence of occlusion.
Conclusions:
- VTM effectively visualizes collateral circulation changes in ischemic stroke.
- The findings contribute to understanding the hemodynamics of large vessel occlusion.
