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Beyond ASPECTS: A Practical Guide to CT Perfusion Interpretation.

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Computed tomography perfusion (CTP) imaging is crucial for acute ischemic stroke (AIS) evaluation, guiding endovascular thrombectomy decisions. This review offers practical guidance for accurate CTP interpretation in clinical practice.

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Area of Science:

  • Neuroradiology
  • Medical Imaging
  • Neurology

Background:

  • Computed tomography perfusion (CTP) is vital for acute ischemic stroke (AIS) assessment.
  • Accurate CTP interpretation is essential for identifying candidates for endovascular thrombectomy.
  • Clinical challenges necessitate a structured approach to CTP analysis.

Purpose of the Study:

  • To provide a theoretical foundation and practical guidance for interpreting CTP in AIS.
  • To address real-world clinical challenges in CTP analysis.
  • To enhance clinicians' knowledge for consistent and effective CTP utilization.

Main Methods:

  • Review of current American Heart Association/American Stroke Association (AHA/ASA) guidelines.
  • Discussion of institutional best practices for CTP interpretation.
  • Integration of theoretical concepts with practical, case-based examples and annotated images.

Main Results:

  • Illustrates key CTP concepts through real clinical scenarios.
  • Highlights challenging cases where CTP significantly impacts treatment decisions.
  • Emphasizes the importance of integrating technical understanding, clinical judgment, and modality limitations.

Conclusions:

  • Effective CTP interpretation requires a structured, multi-faceted approach.
  • CTP plays a pivotal role in optimizing treatment selection for AIS patients.
  • This review equips clinicians with tools for consistent and effective CTP use in stroke management.