title: Cerebral perfusion impairment correlates with the decrease of CT density in acute ischaemic stroke.
abstract: Within the first 6 h of ischaemic stroke, changes on computed tomography (CT) scans are known as early ischaemic signs. We tested the hypothesis that the severity of perfusion impairment correlates with the degree of CT density decrease. Water uptake in ischaemic brain tissue results in a subtle decrease of CT density, and was quantified by delineation of the corresponding decrease of the apparent diffusion coefficient (ADC). Regions of decreased ADC and CT density in 29 acute-stroke patients were superimposed on the corresponding magnetic resonance perfusion images. Mean values of ADC and CT density decrease were correlated with the corresponding relative changes of cerebral blood flow (rCBF) and volume (rCBV), mean transit time (rMTT) and time-to-peak (rTTP). The decrease of CT density was 1.2 +/- 0.6 Hounsfield units and showed a linear correlation with rCBF (0.42, p < 0.01) as well as rCBV (0.62, p < 0.01), but not with the prolongation of rMTT (1.43, p = 0.78) or rTTP (1.34, p = 0.26). Therefore, the reduction of rCBF determines the severity of the early ischaemic oedema (EIOE) on CT, as well as reduction of the ADC. These findings provide a coherent view on the pathophysiology of the EIOE.
authors.affiliation: Department of Neuroradiology, University-Hospital Hamburg Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany. kucinski@uke.uni-hamburg.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Kucinski
authors.forename: Amitava
authors.initials: A
authors.lastname: Majumder
authors.forename: René
authors.initials: R
authors.lastname: Knab
authors.forename: Dirk
authors.initials: D
authors.lastname: Naumann
authors.forename: Jens
authors.initials: J
authors.lastname: Fiehler
authors.forename: Ole
authors.initials: O
authors.lastname: Väterlein
authors.forename: Bernd
authors.initials: B
authors.lastname: Eckert
authors.forename: Joachim
authors.initials: J
authors.lastname: Röther
authors.forename: Hermann
authors.initials: H
authors.lastname: Zeumer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology; D001810:Blood Volume / Q000502:physiology; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003287:Contrast Media; D004058:Diffusion; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media