CT perfusion scanning with deconvolution analysis: pilot study in patients with acute middle cerebral artery stroke.
OBJECTIVE
To measure mean cerebral blood flow (CBF) in ischemic and nonischemic territories and in low-attenuation regions in patients with acute stroke by using deconvolution-derived hemodynamic imaging.


METHODS
Twelve patients with acute middle cerebral artery stroke and 12 control patients were examined by using single-section computed tomography (CT) perfusion scanning. Analysis was performed with a deconvolution-based algorithm. Comparisons of mean CBF, cerebral blood volume (CBV), and mean transit time (MTT) were determined between hemispheres in all patients and between low- and normal-attenuation regions in patients with acute stroke. Two independent readers examined the images for extent of visually apparent regional perfusion abnormalities. The data were compared with extent of final infarct in seven patients with acute stroke who underwent follow-up CT or magnetic resonance imaging.


RESULTS
Significant decreases in CBF (-50%, P =.001) were found in the affected hemispheres of patients with acute stroke. Significant changes in CBV (-26%, P =.03) and MTT (+111%, P =.004) were also seen. Significant alterations in perfusion were also seen in low- compared with normal-attenuation areas. Pearson correlation between readers for extent of CBF abnormality was 0.94 (P =.001). Intraobserver variation was 8.9% for CBF abnormalities.


CONCLUSIONS
Deconvolution analysis of CT perfusion data is a promising method for evaluation of cerebral hemodynamics in patients with acute stroke.
Eastwood
James D
JD
Depts of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710-3808, USA. eastw004@mc.duke.edu
Lev
Michael H
MH
Azhari
Tarek
T
Lee
Ting-Yim
TY
Barboriak
Daniel P
DP
Delong
David M
DM
Fitzek
Clemens
C
Herzau
Michael
M
Wintermark
Max
M
Meuli
Reto
R
Brazier
David
D
Provenzale
James M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012039:Regional Blood Flow; D020521:Stroke / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*