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Multiphasic Perfusion Computed Tomography in Hyperacute Ischemic Stroke: Comparison with Diffusion and Perfusion Magnetic Resonance Imaging

Authors
 Na Dong Gyu  ;  Ryoo Jae Wook  ;  Byun Hong Sik  ;  Kim Jae Hyoung  ;  Yi Byong Yong  ;  Lee Soo Joo  ;  Kim Eung Yeop  ;  Yi Chin A.  ;  Moon Chan Hong  ;  Lee Kwang Ho 
Citation
 JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, Vol.27(2) : 194-206, 2003 
Journal Title
 JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY 
ISSN
 0363-8715 
Issue Date
2003
MeSH
Acute Disease ; Aged ; Aged, 80 and over ; Brain/blood supply ; Brain/diagnostic imaging ; Brain/physiopathology ; Brain Ischemia/diagnosis* ; Brain Ischemia/pathology ; Carotid Artery, Internal/diagnostic imaging ; Carotid Artery, Internal/pathology ; Carotid Stenosis/diagnosis ; Cerebrovascular Circulation/physiology ; Diffusion Magnetic Resonance Imaging ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Predictive Value of Tests ; Severity of Illness Index ; Statistics as Topic ; Stroke/diagnosis* ; Stroke/pathology ; Time Factors ; Tomography, X-Ray Computed*
Keywords
computed tomography (CT) ; magnetic resonance imaging (MRI) ; ischemia ; perfusion ; diffusion ; brain
Abstract
PURPOSE: The purpose of this study was to compare multiphasic perfusion computed tomography (CT) with diffusion and perfusion magnetic resonance imaging (MRI) in predicting final infarct volume, infarct growth, and clinical severity in patients with hyperacute ischemia untreated by thrombolytic therapy. METHOD: Multiphasic perfusion CT was performed in 19 patients with ischemic stroke within 6 hours of symptom onset. Two CT maps of peak and total perfusion were generated from CT data. Diffusion-weighted imaging (DWI) and perfusion MRI were obtained within 150 minutes after CT. Lesion volumes on CT and MRI were compared with final infarct volume and clinical scores, and mismatch on CT or MRI was compared with infarct growth. RESULTS: The lesion volume on the CT total perfusion map strongly correlated with MRI relative cerebral blood volume (rCBV), and that on the CT peak perfusion map strongly correlated with MRI relative cerebral blood flow (rCBF) and rCBV (P < 0.001). The lesion volume on unenhanced CT or DWI moderately correlated with final infarct volume, but only lesion volume on unenhanced CT weakly correlated with baseline clinical scores (P = 0.024). The lesion volumes on the CT peak perfusion map and MRI rCBF similarly correlated with final infarct volume and clinical scores and more strongly than those on mean transit time (MTT) or time to peak (TTP). DWI-rCBF or CT mismatch was more predictive of infarct growth than DWI-MTT or DWI-TTP mismatch. CONCLUSION: Multiphasic perfusion CT is useful and of comparable utility to diffusion and perfusion MRI for predicting final infarct volume, infarct growth, and clinical severity in acute ischemic stroke.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00004728-200303000-00016&LSLINK=80&D=ovft
DOI
OAK-2003-01208
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eung Yeop(김응엽)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/114368
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