Cerebral Blood Flow Is the Optimal CT Perfusion Parameter for Assessing Infarct Core
Top Cited Papers
- 1 December 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 42 (12), 3435-3440
- https://doi.org/10.1161/strokeaha.111.618355
Abstract
Background and Purpose— CT perfusion (CTP) is widely and rapidly accessible for imaging acute ischemic stroke but has limited validation. Cerebral blood volume (CBV) has been proposed as the best predictor of infarct core. We tested CBV against other common CTP parameters using contemporaneous diffusion MRI. Methods— Patients with acute ischemic stroke Results— In analysis of 98 CTP slabs (54 patients, median onset to CT 190 minutes, median CT to MR 30 minutes), relative CBF performed best (AUC, 0.79; 95% CI, 0.77–81), significantly better than absolute CBV (AUC, 0.74; 95% CI, 0.73–0.76). The optimal threshold was Conclusions— In contrast to previous reports, CBF corresponded with the acute diffusion-weighted imaging lesion better than CBV, although no single threshold avoids detection of false-positive regions in unaffected white matter. This relates to low signal-to-noise ratio in CTP maps and emphasizes the need for optimized acquisition and postprocessing.Keywords
This publication has 20 references indexed in Scilit:
- Ischemic diffusion lesion reversal is uncommon and rarely alters perfusion-diffusion mismatchNeurology, 2010
- Evidence-based guideline: The role of diffusion and perfusion MRI for the diagnosis of acute ischemic stroke [RETIRED]Neurology, 2010
- Pretreatment Diffusion- and Perfusion-MR Lesion Volumes Have a Crucial Influence on Clinical Response to Stroke ThrombolysisJournal of Cerebral Blood Flow & Metabolism, 2010
- Differences in CT Perfusion Maps Generated by Different Commercial Software: Quantitative Analysis by Using Identical Source Data of Acute Stroke PatientsRadiology, 2010
- Theoretic Basis and Technical Implementations of CT Perfusion in Acute Ischemic Stroke, Part 2: Technical ImplementationsAmerican Journal of Neuroradiology, 2009
- Breaking the 3 h barrier for treatment of acute ischaemic strokeThe Lancet Neurology, 2008
- Perfusion CT: Is it Clinically Useful?International Journal of Stroke, 2008
- Perfusion-CT Assessment of Infarct Core and PenumbraStroke, 2006
- Comparison of Perfusion Computed Tomography and Computed Tomography Angiography Source Images With Perfusion-Weighted Imaging and Diffusion-Weighted Imaging in Patients With Acute Stroke of Less Than 6 Hours’ DurationStroke, 2004
- New imaging strategies for patient selection for thrombolytic and neuroprotective therapiesNeurology, 2001