Whole brain perfused blood volume CT: visualization of infarcted tissue compared to quantitative perfusion CT.
OBJECTIVE
This study determines the value of whole brain color-coded three-dimensional perfused blood volume (PBV) computed tomography (CT) for the visualization of the infarcted tissue in acute stroke patients.


METHODS
Nonenhanced CT (NECT), perfusion CT (PCT), and CT angiography (CTA) in 48 patients with acute ischemic stroke were performed. Whole brain PBV was calculated from NECT and CTA data sets using commercial software. PBV slices in identical orientation to the PCT slices were reconstructed and the area of visual perfusion abnormality on PBV maps was measured. The infarct core in the corresponding PCT slices (CBV <2.0 mL/100 g) was measured automatically with commercial software. The ischemic area on PBV and the infarct core on quantitative PCT were compared using the Pearsons-R correlation coefficient. Significance was considered for P < .05.


RESULTS
The quantitative PCT demonstrated a mean infarct core volume of 35.48 +/- 32.17 cm(3), whereas the volume of visual perfusion abnormality of the corresponding PBV slices was 37.16 +/- 37.59 cm(3). The perfusion abnormality in PBV was highly correlated with the infarct core of quantitative PCT for area per slice (r = 0.933, P < .01) as well as volume (r = 0.922, P < .01).


CONCLUSIONS
PBV can serve as surrogate marker corresponding to the infarct core in acute stroke with whole brain coverage.
Wittkamp
Gunnar
G
Department of Clinical Radiology, University of Muenster, 48149 Muenster, Germany.
Buerke
Boris
B
Dziewas
Rainer
R
Ditt
Hendrik
H
Seidensticker
Peter
P
Heindel
Walter
W
Kloska
Stephan P
SP
D000368:Aged; D000465:Algorithms; D001921:Brain / Q000000981:diagnostic imaging*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*