Feasibility of cerebral blood volume mapping by flat panel detector CT in the angiography suite: first experience in patients with acute middle cerebral artery occlusions.
OBJECTIVE
A new FPCT application offers the possibility of perfusion (FPCT CBV) and parenchymal (FPCT) imaging within the angiography suite. We tested the hypothesis that findings in FPCT CBV and FPCT would correlate with those obtained using MSCT and PCT.


METHODS
In 16 patients with acute MCA occlusion, FPCT CBV was performed immediately posttreatment. The volume of tissue having abnormal CBV values was determined by FPCT CBV and PCT images. Stroke volume on follow-up MSCT was determined, CBV values in the effected parenchyma were measured, and FPCT images were reviewed.


RESULTS
In 6 cases, we found a FPCT CBV value identical or higher (hyperemia) in comparison with the contralateral side. In 10 cases, we found CBV lesions with values lower (oligemia) than the contralateral brain tissue. We found a high correlation of CBV lesion volume on FPCT CBV images to stroke volume on follow-up MSCT (r = 0.9, P < .05) in the oligemia group. Absolute FPCT CBV and PCT CBV values were comparable and showed good correlation (r = 0.9, P < .05). In 8 patients, contrast medium extravasation was visible.


CONCLUSIONS
The new FPCT application allows assessment of CBV in acute stroke patients. Our initial results indicate that these measurements may predict final infarct volume. The ability to assess this key parameter of cerebral perfusion within the angiographic suite may improve the management of these patients.
Department of Neuroradiology, University of Erlangen-Nuernberg, Erlangen, Germany. tobias.struffert@uk-erlangen.de
T
T
Struffert
Y
Y
Deuerling-Zheng
T
T
Engelhorn
S
S
Kloska
P
P
Gölitz
M
M
Köhrmann
S
S
Schwab
C M
CM
Strother
A
A
Doerfler
D000368:Aged; D001783:Blood Flow Velocity; D001811:Blood Volume Determination / Q000295:instrumentation* / Q000379:methods; D002533:Cerebral Angiography / Q000295:instrumentation*; D002560:Cerebrovascular Circulation; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D010865:Pilot Projects; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome