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Identification of infarct core and penumbra in acute stroke using CT perfusion source images.

AbstractBACKGROUND AND PURPOSE:
CT perfusion (CTP) mapping has been reported to be useful in the differentiation of the infarct core and ischemic penumbra. However, the value of the CTP source imaging (CTP-SI) during the arterial and venous phases has not been fully investigated. The purpose of this study was to develop a CTP-SI methodology for acute ischemic stroke and compare its efficacy with cerebral blood flow (CBF) and cerebral blood volume (CBV) in predicting infarct core and penumbra.
MATERIALS AND METHODS:
CT examinations, including non-contrast-enhanced CT, CTP, and CT angiography (CTA), were performed in 42 patients with symptoms of stroke for <9 hours. The Alberta Stroke Program Early CT Score (ASPECTS) was analyzed on the arterial phase CTP-SI and venous phase CTP-SI and then compared with the ASPECTS on CBF and CBV for efficacy assessment.
RESULTS:
The ASPECTS on the arterial phase CTP-SI was closely correlated with the ASPECTS on CBF, the Pearson correlation coefficient was 0.88 (P < .001), and the concordance correlation coefficient was 0.7603 (95% confidence interval [CI], 0.6331-0.8476). The ASPECTS on the venous phase CTP-SI revealed a significant correlation with the ASPECTS on CBV, the Pearson correlation coefficient was 0.92 (P < .001), and the concordance correlation coefficient was 0.8880 (95% CI, 0.8148-0.9334). Significant differences were shown between the arterial phase CTP-SI/ venous phase CTP-SI (P < .001) and CBF/CBV (P < .001).
CONCLUSIONS:
This study provides preliminary evidence that the arterial phase and venous phase CTP-SI mismatch model could possibly be applied to ischemic regions in the acute stage of stroke to determine penumbra and infarct core.
AuthorsX-C Wang, P-Y Gao, J Xue, G-R Liu, L Ma
JournalAJNR. American journal of neuroradiology (AJNR Am J Neuroradiol) Vol. 31 Issue 1 Pg. 34-9 (Jan 2010) ISSN: 1936-959X [Electronic] United States
PMID19875465 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Acute Disease
  • Blood Volume
  • Brain Infarction (diagnostic imaging, physiopathology)
  • Brain Ischemia (diagnostic imaging, physiopathology)
  • Cerebrovascular Circulation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Stroke (diagnostic imaging, physiopathology)
  • Tomography, X-Ray Computed (methods)

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