Reliability of CT Perfusion in the Evaluation of the Ischaemic Penumbra

• DOI: 10.15274/nrj-2014-10010
• Publication Date: 2014-03-31T13:11:24Z
• Authors: José Eduardo Alves; Ângelo Carneiro; João Xavier
• Keywords: Penumbra; Stroke; Mean transit time

CT perfusion (CTP) is part of the initial evaluation stroke patients, allowing differentiation between infarcted tissue and ischaemic penumbra helping in selection patients for endovascular treatment. This study assessed reliability qualitative CTP maps defining ischemic identified potential pitfalls associated with this technique. We reviewed scans 45 consecutive admitted to our institution anterior circulation acute stroke. Two neuroradiologists performed evaluations cerebral blood volume (CBV) mean transit time (MTT) maps, using 24h follow-up non-contrast as surrogate marker area definitive infarct. For each slice analyzed, alteration CBV MTT was classified either being inferior, equal or superior infarct on CT. Three out (7%) had admission abnormalities larger than lesions; 34/45 (76%) areas smaller prolongation. In group no recanalization 12/19 (63%) lesion. abnormality a reliable an irreversible lesion, although rarely it may overestimate "core", possibly due delay contrast arrival brain. majority without recanalization, overestimated final areas, probably because does not differentiate true "at risk" from benign oligaemia. Qualitative real penumbra.