C-Arm CT Measurement of Cerebral Blood Volume in Ischemic Stroke: An Experimental Study in Canines

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
Fig 1.
A−C, DSA with selective ICA injection pre- (A) and postembolization (B) at the origin of the ICA, resulting in an occlusion of the right MCA (arrow in B). C, DWI performed 4 hours later confirms the presence of a right MCA infarct (arrow). D, C-arm CT and PCT (E) demonstrate corresponding decreased CBV as determined both by the color maps and measured values in the respective regions of interest. CBV values are in milliliters per 100 grams of brain tissue.
Download figure
Open in new tab
Download powerpoint
Fig 2.
A and B, DSA with selective ICA injection pre-embolization demonstrates tortuosity of the ICA (asterisk in A). Embolization was performed near the origin of the right MCA, from a vertebral artery approach leading to occlusion of the proximal MCA. MCA infarct (arrow) was validated by DWI (C) done 4 hours after embolization. C-arm CT (D) and PCT (E) reveal corresponding decreased CBV as determined both by the color maps and measured values in the respective regions of interest.

Table 1:

Mean CBV values in regions of interest^a

a Mean CBV values in the regions of interest within the infarcted territory (infarct) and in the normal contralateral side (normal) in the 10 canine experiments.
b Paired 2-sample t test.
c 1 indicates 1 mL/s; C-arm 1, values from the first C-arm CT acquisition.
d C-arm 2 indicates values from the second C-arm CT acquisition.

Table 3:

Readers' performance in evaluating PCT and C-arm CT images^a

	Reader 1	Reader 2	Reader 3	Mean
TP readings of PCT	75.0%	70%	75%	73.3%
TP readings of C-arm CT	83.3%	83.3%	86.7%	84.4%
FP readings of PCT	0%	5%	0%	1.7%
FP readings of C-arm CT	0%	3.3%	6.7%	3.3%
FN readings of PCT	25%	25%	25%	25%
FN readings of C-arm CT	16.7%	13.3%	6.7%	12.2%

a Percentage of TP (infarct was correctly identified), FP (CBV abnormality identified in a location where there was no DWI abnormality), and FN (no abnormality identified in location where there was a DWI abnormality) readings are given for each reader individually and the mean of all 3 readers. C-arm CT readings demonstrate a better correlation with the criterion standard DWI. Most interesting, the rate of FP readings is very low. Please note the discrepancy of FN PCT and FN C-arm CT readings.