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A new method for quantitative regional cerebral blood volume measurements using computed tomography
J P Muizelaar1, P P Fatouros, M L Schröder
1Department of Neurological Surgery, University of California, Davis, Sacramento 95817, USA.
Stroke
|October 28, 1997
Summary
This study introduces a new method for measuring cerebral blood volume (CBV) using CT scans. The technique accurately quantifies CBV changes, aiding in the diagnosis of stroke and head injuries.
Area of Science:
- Neuroradiology
- Medical Imaging
- Cerebrovascular Physiology
Background:
- Cerebral blood volume (CBV) is crucial for understanding brain swelling in stroke and head injury.
- Accurate CBV measurement aids clinical decisions in hemodynamic transient ischemic attacks (TIAs).
Purpose of the Study:
- To develop and clinically apply a novel method for quantitative regional CBV measurements.
- To establish a rapid and easily implemented technique for CBV assessment using CT scanners.
Main Methods:
- The method combines cerebral blood flow (CBF) measurements (xenon/CT) with tissue mean transit time (MTT) (dynamic CT) after contrast injection.
- CBV maps are generated by multiplying CBF and MTT maps, adhering to the Central Volume Principle (CBV = CBF x MTT).
- The technique yields CBV values in milliliters of blood per 100 grams of tissue.
Main Results:
- The method was validated against pressure-volume index (PVI) measurements, showing agreement within 15% for CBV changes.
- Baseline CBV values in normal volunteers averaged 5.3 mL/100 g.
- The method was applied to 71 patients with severe head injuries and 1 patient with TIAs.
Conclusions:
- The developed method accurately determines CBV changes and is consistent with other established techniques.
- Prolonged MTTs and decreased CBF in head injury patients suggest increased cerebrovascular resistance and early ischemia.
- Increased CBV in the hemisphere with an occluded internal carotid artery indicates compensatory vasodilation in TIAs.