title: Color-coded perfused blood volume imaging using multidetector CT: initial results of whole-brain perfusion analysis in acute cerebral ischemia.
abstract: Computed tomography (CT) is still the primary imaging modality following acute stroke. To evaluate a prototype of software for the calculation of color-coded whole-brain perfused blood volume (PBV) images from CT angiography (CTA) and nonenhanced CT (NECT) scans, we studied 14 patients with suspected acute ischemia of the anterior cerebral circulation. PBV calculations were performed retrospectively. The detection rate of ischemic changes in the PBV images was compared with NECT. The volume of ischemic changes in PBV was correlated with the infarct volume on follow-up examination taking potential vessel recanalization into account. PBV demonstrated ischemic changes in 12/12 patients with proven infarction and was superior to NECT (8/12) in the detection of early ischemia. Moreover, PBV demonstrated the best correlation coefficient with the follow-up infarct volume (Pearson's R = 0.957; P = 0.003) for patients with proven recanalization of initially occluded cerebral arteries. In summary, PBV appears to be more accurate in the detection of early infarction compared to NECT and mainly visualizes the irreversibly damaged ischemic tissue.
authors.affiliation: Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Str. 33, 48149 Muenster, Germany. kloska@uni-muenster.de
authors.forename: Stephan P
authors.initials: SP
authors.lastname: Kloska
authors.forename: Tobias
authors.initials: T
authors.lastname: Fischer
authors.forename: Darius G
authors.initials: DG
authors.lastname: Nabavi
authors.forename: Ralf
authors.initials: R
authors.lastname: Dittrich
authors.forename: Hendrik
authors.initials: H
authors.lastname: Ditt
authors.forename: Ernst
authors.initials: E
authors.lastname: Klotz
authors.forename: Roman
authors.initials: R
authors.lastname: Fischbach
authors.forename: E Bernd
authors.initials: EB
authors.lastname: Ringelstein
authors.forename: Walter
authors.initials: W
authors.lastname: Heindel
mesh_terms: D000208:Acute Disease; D000368:Aged; D000465:Algorithms; D001810:Blood Volume; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002533:Cerebral Angiography; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012984:Software; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide