(Stroke. 2001;32:175.)
© 2001 American Heart Association, Inc.
Original Contributions |
Perfusion Mapping Using Computed Tomography Allows Accurate Prediction of Cerebral Infarction in Experimental Brain Ischemia
Presented in part at the 19th International Symposium on Cerebral Blood Flow, Metabolism, and Function, June 13–17, 1999, Copenhagen, Denmark, and published in abstract form (J Cereb Blood Flow Metab. 1999;19[suppl 1]:S586).
From the Imaging Research Laboratories, John P. Robarts Research Institute, London, Ontario, Canada (D.G.N., A.C., S.H., T-Y.L.); Department of Neurology, Westfälische Wilhelms-Universität, Münster, Germany (D.G.N.); Department of Anesthesia, London Health Sciences Center, University of Western Ontario, London, Ontario, Canada (S.H., A.W.G.); and Imaging Division, Lawson Research Institute, London, Ontario, Canada (T-Y.L.).
Correspondence to Ting-Yim Lee, PhD, Imaging Research Laboratories, John P. Robarts Research Institute, PO Box 5015, London, Ontario, N6A 5K8. E-mail tlee{at}irus.rri.on.ca
Background and Purpose—We have developed a dynamic CT method to measure absolute cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). In this study we evaluated the ability of CT-derived functional maps to detect infarction in a rabbit model of focal cerebral ischemia.
Methods—Sequential dynamic CT studies were performed at 2 different slices in 5 control rabbits and another 8 after induction of focal cerebral ischemia. The size of critically ischemic tissue was correlated to size of infarction measured by postmortem 2,3,5-triphenyltetrazolium chloride staining. In the control rabbits, short-term variability of the parameters was assessed by ANOVA analysis.
Results—In 7 of 8 animals of the ischemia group, cerebral infarction was visible on 2,3,5-triphenyltetrazolium chloride staining, constituting 16.7±10.6% of the ipsilateral hemisphere. Good agreement of CBF functional maps with tissue specimens was found with respect to size and location of infarction. Best prediction of infarction was found for thresholds of CBF <10 mL/100 g per minute (mean size, 17.5±13.4%; r=0.95) and MTT >6 seconds (mean size, 15.6±13.5%; r=0.85), with regression slopes close to unity. CBV maps were less predictive of occurrence of infarction, especially in cases of small infarction. The short-term variability of CBF, CBV, and MTT in the control group was 10.9%, 15.2%, and 19.9%, respectively.
Conclusions—Functional CT measurements of absolute CBF and MTT early after onset of ischemia allow prediction of the size and location of cerebral infarction with good accuracy.
Editorial Comment
Presented in part at the 19th International Symposium on Cerebral Blood Flow, Metabolism, and Function, June 13–17, 1999, Copenhagen, Denmark, and published in abstract form (J Cereb Blood Flow Metab. 1999;19[suppl 1]:S586).
Departments of Neurology, Neuroscience, and, Cell Biology and Physiology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
This article has been cited by other articles:
 |
|
 |
|
  R. E. Latchaw, M. J. Alberts, M. H. Lev, J. J. Connors, R. E. Harbaugh, R. T. Higashida, R. Hobson, C. S. Kidwell, W. J. Koroshetz, V. Mathews, et al. Recommendations for Imaging of Acute Ischemic Stroke: A Scientific Statement From the American Heart Association Stroke, November 1, 2009; 40(11): 3646 - 3678. [Full Text] [PDF]
|
|
|
|
 |
|
 A.C. Miracle, A. Rezaei, D. Gandhi, and S.K. Mukherji CT Perfusion of the Neck: Internal Carotid Artery versus External Carotid Artery as the Reference Artery AJNR Am. J. Neuroradiol., September 1, 2009; 30(8): 1598 - 1601. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Sheikh, M. J. Schipper, and E. G. Hoeffner Feasibility of Superficial Temporal Artery as the Input Artery for Cerebral Perfusion CT Am. J. Roentgenol., June 1, 2009; 192(6): W321 - W329. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.A. Konstas, G.V. Goldmakher, T.-Y. Lee, and M.H. Lev Theoretic Basis and Technical Implementations of CT Perfusion in Acute Ischemic Stroke, Part 1: Theoretic Basis AJNR Am. J. Neuroradiol., April 1, 2009; 30(4): 662 - 668. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Zhao, D. C. Alsop, A. AbdulJalil, M. Selim, L. Lipsitz, P. Novak, L. Caplan, K. Hu, and V. Novak Vasoreactivity and peri-infarct hyperintensities in stroke Neurology, February 17, 2009; 72(7): 643 - 649. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. G. Sheiman and A. Sitek Feasibility of Measurement of Pancreatic Perfusion Parameters with Single-Compartment Kinetic Model Applied to Dynamic Contrast-enhanced CT Images Radiology, December 1, 2008; 249(3): 878 - 882. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.M. Silvennoinen, L.M. Hamberg, P.J. Lindsberg, L. Valanne, and G.J. Hunter CT Perfusion Identifies Increased Salvage of Tissue in Patients Receiving Intravenous Recombinant Tissue Plasminogen Activator within 3 Hours of Stroke Onset AJNR Am. J. Neuroradiol., June 1, 2008; 29(6): 1118 - 1123. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Lin, K.S. Kazmi, M. Law, J. Babb, N. Peccerelli, and B.K. Pramanik Measuring Elevated Microvascular Permeability and Predicting Hemorrhagic Transformation in Acute Ischemic Stroke Using First-Pass Dynamic Perfusion CT Imaging AJNR Am. J. Neuroradiol., August 1, 2007; 28(7): 1292 - 1298. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G TAN and T GODDARD Neuroimaging applications of multislice CT perfusion Imaging, June 1, 2007; 19(2): 142 - 152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B.D. Murphy, X. Chen, and T.-Y. Lee Serial Changes in CT Cerebral Blood Volume and Flow after 4 Hours of Middle Cerebral Occlusion in an Animal Model of Embolic Cerebral Ischemia AJNR Am. J. Neuroradiol., April 1, 2007; 28(4): 743 - 749. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R.G. Gonzalez Imaging-guided acute ischemic stroke therapy: From "time is brain" to "physiology is brain". AJNR Am. J. Neuroradiol., April 1, 2006; 27(4): 728 - 735. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.M. Laslo, J.D. Eastwood, F.-X. Chen, and T.-Y. Lee Dynamic CT Perfusion Imaging in Subarachnoid Hemorrhage-Related Vasospasm AJNR Am. J. Neuroradiol., March 1, 2006; 27(3): 624 - 631. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Sitek and R. G. Sheiman Small-Bowel Perfusion Measurement: Feasibility with Single-Compartment Kinetic Model Applied to Dynamic Contrast-enhanced CT Radiology, November 1, 2005; 237(2): 670 - 674. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. Kloska, D. G. Nabavi, C. Gaus, E.-M. Nam, E. Klotz, E. B. Ringelstein, and W. Heindel Acute Stroke Assessment with CT: Do We Need Multimodal Evaluation? Radiology, October 1, 2004; 233(1): 79 - 86. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. G. Hoeffner, I. Case, R. Jain, S. K. Gujar, G. V. Shah, J. P. Deveikis, R. C. Carlos, B. G. Thompson, M. R. Harrigan, and S. K. Mukherji Cerebral Perfusion CT: Technique and Clinical Applications Radiology, June 1, 2004; 231(3): 632 - 644. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Kealey, V. A. Loving, D. M. Delong, and J. D. Eastwood User-defined Vascular Input Function Curves: Influence on Mean Perfusion Parameter Values and Signal-to-Noise Ratio Radiology, May 1, 2004; 231(2): 587 - 593. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. E. Latchaw, H. Yonas, G. J. Hunter, W. T.C. Yuh, T. Ueda, A. G. Sorensen, J. L. Sunshine, J. Biller, L. Wechsler, R. Higashida, et al. Guidelines and Recommendations for Perfusion Imaging in Cerebral Ischemia: A Scientific Statement for Healthcare Professionals by the Writing Group on Perfusion Imaging, From the Council on Cardiovascular Radiology of the American Heart Association Stroke, April 1, 2003; 34(4): 1084 - 1104. [Full Text] [PDF]
|
|
|
|
|
|
K. Kudo, S. Terae, C. Katoh, M. Oka, T. Shiga, N. Tamaki, and K. Miyasaka Quantitative Cerebral Blood Flow Measurement with Dynamic Perfusion CT Using the Vascular-Pixel Elimination Method: Comparison with H215O Positron Emission Tomography AJNR Am. J. Neuroradiol., March 1, 2003; 24(3): 419 - 426. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Eastwood, M. H. Lev, and J. M. Provenzale Perfusion CT with Iodinated Contrast Material Am. J. Roentgenol., January 1, 2003; 180(1): 3 - 12. [Full Text] [PDF]
|
|
|
|
|
|
D. G. Nabavi, S. P. Kloska, E.-M. Nam, M. Freund, C. G. Gaus, E. Klotz, W. Heindel, and E. B. Ringelstein MOSAIC: Multimodal Stroke Assessment Using Computed Tomography: Novel Diagnostic Approach for the Prediction of Infarction Size and Clinical Outcome Stroke, December 1, 2002; 33(12): 2819 - 2826. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Gladstone, S. E. Black, and A. M. Hakim Toward Wisdom From Failure: Lessons From Neuroprotective Stroke Trials and New Therapeutic Directions Stroke, August 1, 2002; 33(8): 2123 - 2136. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. C. Roberts, T. P.L. Roberts, T.-Y. Lee, and W. P. Dillon Dynamic, Contrast-Enhanced CT of Human Brain Tumors: Quantitative Assessment of Blood Volume, Blood Flow, and Microvascular Permeability: Report of Two Cases AJNR Am. J. Neuroradiol., May 1, 2002; 23(5): 828 - 832. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Eastwood, M. H. Lev, T. Azhari, T.-Y. Lee, D. P. Barboriak, D. M. Delong, C. Fitzek, M. Herzau, M. Wintermark, R. Meuli, et al. CT Perfusion Scanning with Deconvolution Analysis: Pilot Study in Patients with Acute Middle Cerebral Artery Stroke Radiology, January 1, 2002; 222(1): 227 - 236. [Abstract] [Full Text] [PDF]
|
|