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[Dynamic cranial CT in ischemic cerebral lesions]
C Rozeik1, O Kotterer, A Wieschen
1Radiologie I, Strahleninstitut der Städtischen Kliniken Darmstadt.
Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|April 1, 1993
Summary
Dynamic CT effectively detects cerebral perfusion abnormalities in patients with carotid stenosis and neurologic deficits. It identifies infarcts early, even before morphological changes appear, aiding diagnosis.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Carotid stenosis is a significant risk factor for cerebrovascular events.
- Accurate assessment of cerebral perfusion is crucial for diagnosing and managing neurologic deficits.
- Early detection of perfusion abnormalities can improve patient outcomes.
Purpose of the Study:
- To evaluate the utility of dynamic computed tomography (CT) in assessing cerebral perfusion in patients with neurologic deficits and carotid stenosis.
- To correlate dynamic CT findings with the presence of cerebral infarcts and transient ischemic attacks (TIAs).
- To compare dynamic CT findings with technetium-99m-labeled hexamethylpropyleneamine oxime single-photon emission computed tomography (99mTc-HMPAO-SPECT).
Main Methods:
- Dynamic CT was performed at the level of the internal capsule in 58 patients with recent transient or permanent neurologic deficits and proven carotid stenoses.
- Time/density curves were analyzed to assess cerebral perfusion.
- Findings were correlated with the presence of cerebral infarcts, TIAs, and carotid stenosis severity.
- Comparison with 99mTc-HMPAO-SPECT results was conducted.
Main Results:
- Dynamic CT showed marked delay and reduced peaks in time/density curves in the presence of cerebral infarcts.
- Abnormal perfusion was detectable by dynamic CT before morphological changes were evident.
- Transient ischemic attacks (TIAs) did not show significant perfusion changes, while carotid stenosis results were variable.
- Perfusion abnormalities identified by dynamic CT were partially confirmed by 99mTc-HMPAO-SPECT.
Conclusions:
- Dynamic CT is a valuable tool for detecting cerebral perfusion abnormalities in patients with neurologic deficits and carotid stenosis.
- It allows for early identification of infarcts and can detect perfusion deficits prior to morphological changes.
- Dynamic CT findings show partial agreement with 99mTc-HMPAO-SPECT, suggesting its complementary role in neuroimaging.