CT angiography with whole brain perfused blood volume imaging: Added clinical value in the assessment of acute stroke

In CT angiographic and perfusion imaging (CTA/CTP), rapid CT scanning is performed during the brief steady state administration of a contrast bolus, creating both vascular phase images of the major intracranial vessels and perfused blood volume-weighted parenchymal phase images of the entire brain....

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Bibliographic Details
Published in:Stroke (1970) 2002-04, Vol.33 (4), p.959-966
Main Authors: EZZEDDINE, Mustapha A, LEV, Michael H, KOROSHETZ, Walter J, MCDONALD, Colin T, RORDORF, Guy, OLIVEIRA-FILHO, Jamary, GUL AKSOY, Fatma, FARKAS, Jeffrey, SEGAL, Alan Z, SCHWAMM, Lee H, GONZALEZ, R. Gilberto
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Brain - blood supply
Brain - diagnostic imaging
Contrast Media
Female
Follow-Up Studies
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Nervous system
Neurology
Predictive Value of Tests
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Reproducibility of Results
Retrospective Studies
Stroke - classification
Stroke - diagnosis
Stroke - therapy
Time Factors
Tomography, X-Ray Computed - methods
Vascular diseases and vascular malformations of the nervous system
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Summary:In CT angiographic and perfusion imaging (CTA/CTP), rapid CT scanning is performed during the brief steady state administration of a contrast bolus, creating both vascular phase images of the major intracranial vessels and perfused blood volume-weighted parenchymal phase images of the entire brain. We assessed the added clinical value of the data provided by CTA/CTP over that of clinical examination and noncontrast CT (NCCT) alone. NCCT and CTA/CTP imaging was performed in 40 patients presenting with an acute stroke. Short clinical vignettes were retrospectively prepared. After concurrent review of the vignettes and NCCT, a stroke neurologist rated infarct location, vascular territory, vessel(s) occluded, and Trial of Org 10172 in Acute Stroke Treatment (TOAST) and Oxfordshire Community Stroke Project classifications. The ratings were repeated after serial review of each of the CTA/CTP components: (1) axial CTA source images; (2) CTP whole brain blood volume-weighted source images; and (3) maximum-intensity projection 3-dimensional reformatted images. The sequential ratings for each case were compared with the final discharge assessment. Compared with the initial review after NCCT, CTA/CTP improved the overall accuracy of infarct localization (P
ISSN:0039-2499
1524-4628
DOI:10.1161/hs0402.105388