title: Assessment of cerebral perfusion and arterial anatomy in hyperacute stroke with three-dimensional functional CT: early clinical results.
abstract: OBJECTIVE
  Our purpose was to determine the clinical feasibility of quantitative three-dimensional functional CT in patients with hyperacute stroke.
  
  
  METHODS
  Twenty-two patients who underwent clinically indicated CT angiography were studied: nine patients had no stroke, eight had mature stroke, and five had hyperacute stroke (less than 3 hours since ictus). Maps were obtained of perfused cerebral blood volume (PBV), and CT angiograms were generated by using standard techniques.
  
  
  RESULTS
  Normal PBV values (mean +/- SEM) were 4.6 +/- 0.15% in the gray matter, 1.75 +/- 0.09% in the white matter, 2.91 +/- 0.20% in the cerebellum, 3.18 +/- 0.10% in the caudate, 2.84 +/- 0.23% in the putamen, 2.92 +/- 0.29% in the thalamus, and 1.66 +/- 0.03% in the brain stem. For patients with mature stroke, ischemic changes were visible on noncontrast, contrast-enhanced, and PBV scans. In patients with hyperacute stroke, ischemic changes were either absent or subtle before contrast administration, but became apparent on contrast-enhanced scans. Quantitative PBV maps confirmed reduced regional perfusion. CT angiograms in the hyperacute group showed occlusion of vessels in locations appropriate to the PBV deficits seen.
  
  
  CONCLUSIONS
  Quantitative three-dimensional functional CT is feasible for patients with hyperacute stroke. It is performed by using helical CT techniques, and yields measures of cerebrovascular physiological function, which are useful in this patient population.
authors.affiliation: Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, USA.
authors.forename: G J
authors.initials: GJ
authors.lastname: Hunter
authors.forename: L M
authors.initials: LM
authors.lastname: Hamberg
authors.forename: J A
authors.initials: JA
authors.lastname: Ponzo
authors.forename: F R
authors.initials: FR
authors.lastname: Huang-Hellinger
authors.forename: P P
authors.initials: PP
authors.lastname: Morris
authors.forename: J
authors.initials: J
authors.lastname: Rabinov
authors.forename: J
authors.initials: J
authors.lastname: Farkas
authors.forename: M H
authors.initials: MH
authors.lastname: Lev
authors.forename: P W
authors.initials: PW
authors.lastname: Schaefer
authors.forename: C S
authors.initials: CS
authors.lastname: Ogilvy
authors.forename: L
authors.initials: L
authors.lastname: Schwamm
authors.forename: F S
authors.initials: FS
authors.lastname: Buonanno
authors.forename: W J
authors.initials: WJ
authors.lastname: Koroshetz
authors.forename: G L
authors.initials: GL
authors.lastname: Wolf
authors.forename: R G
authors.initials: RG
authors.lastname: González
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed