title: Perfusion Angiography in Acute Ischemic Stroke.
abstract: Visualization and quantification of blood flow are essential for the diagnosis and treatment evaluation of cerebrovascular diseases. For rapid imaging of the cerebrovasculature, digital subtraction angiography (DSA) remains the gold standard as it offers high spatial resolution. This paper lays out a methodological framework, named perfusion angiography, for the quantitative analysis and visualization of blood flow parameters from DSA images. The parameters, including cerebral blood flow (CBF) and cerebral blood volume (CBV), mean transit time (MTT), time-to-peak (TTP), and T max, are computed using a bolus tracking method based on the deconvolution of the time-density curve on a pixel-by-pixel basis. The method is tested on 66 acute ischemic stroke patients treated with thrombectomy and/or tissue plasminogen activator (tPA) and also evaluated on an estimation task with known ground truth. This novel imaging tool provides unique insights into flow mechanisms that cannot be observed directly in DSA sequences and might be used to evaluate the impact of endovascular interventions more precisely.
authors.affiliation: Department of Neurology, University of California, Los Angeles, Los Angeles, CA 90024, USA.
authors.forename: Fabien
authors.identifier: 0000-0001-9755-8104
authors.initials: F
authors.lastname: Scalzo
authors.affiliation: Department of Neurology, University of California, Los Angeles, Los Angeles, CA 90024, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Liebeskind
mesh_terms: D000368:Aged; D000465:Algorithms; D000792:Angiography; D001783:Blood Flow Velocity; D002545:Brain Ischemia / Q000503:physiopathology*; D002138:Calibration; D002560:Cerebrovascular Circulation; D003720:Densitometry; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010477:Perfusion; D019047:Phantoms, Imaging; D020521:Stroke / Q000503:physiopathology*; D017131:Thrombectomy; D010959:Tissue Plasminogen Activator / Q000378:metabolism; D014741:Video Recording; D014965:X-Rays
chemical_list: D010959:Tissue Plasminogen Activator