Cerebral perfusion CT: technique and clinical applications.
Perfusion computed tomography (CT) is a relatively new technique that allows rapid qualitative and quantitative evaluation of cerebral perfusion by generating maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). The technique is based on the central volume principle (CBF = CBV/MTT) and requires the use of commercially available software employing complex deconvolution algorithms to produce the perfusion maps. Some controversies exist regarding this technique, including which artery to use as input vessel, the accuracy of quantitative results, and the reproducibility of results. Despite these controversies, perfusion CT has been found to be useful for noninvasive diagnosis of cerebral ischemia and infarction and for evaluation of vasospasm after subarachnoid hemorrhage. Perfusion CT has also been used for assessment of cerebrovascular reserve by using acetazolamide challenge in patients with intracranial vascular stenoses who are potential candidates for bypass surgery or neuroendovascular treatment, for the evaluation of patients undergoing temporary balloon occlusion to assess collateral flow and cerebrovascular reserve, and for the assessment of microvascular permeability in patients with intracranial neoplasms. This article is a review of the technique, clinical applications, and controversies surrounding perfusion CT.
Hoeffner
Ellen G
EG
Departments of Radiology and Neurosurgery, University of Michigan Health System, 1500 E Medical Center Drive, University Hospital B2 A209, Ann Arbor, MI 48109, USA. hoeffner@umich.edu
Case
Ian
I
Jain
Rajan
R
Gujar
Sachin K
SK
Shah
Gaurang V
GV
Deveikis
John P
JP
Carlos
Ruth C
RC
Thompson
B Gregory
BG
Harrigan
Mark R
MR
Mukherji
Suresh K
SK
D001810:Blood Volume; D002545:Brain Ischemia / Q000000981:diagnostic imaging; D001932:Brain Neoplasms / Q000098:blood supply; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015203:Reproducibility of Results; D020521:Stroke / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging
D003287:Contrast Media