Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home

User menu

  • Alerts
  • Log in
  • Log out

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

ASHNR American Society of Functional Neuroradiology ASHNR American Society of Pediatric Neuroradiology ASSR
  • Alerts
  • Log in
  • Log out

Advanced Search

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds

AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleBrainF
Open Access

Optimal Brain Perfusion CT Coverage in Patients with Acute Middle Cerebral Artery Stroke

A.D. Furtado, B.C. Lau, E. Vittinghoff, W.P. Dillon, W.S. Smith, T. Rigby, L. Boussel and M. Wintermark
American Journal of Neuroradiology April 2010, 31 (4) 691-695; DOI: https://doi.org/10.3174/ajnr.A1880
A.D. Furtado
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
B.C. Lau
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
E. Vittinghoff
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
W.P. Dillon
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
W.S. Smith
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
T. Rigby
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
L. Boussel
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
M. Wintermark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Responses
  • References
  • PDF
Loading

Abstract

BACKGROUND AND PURPOSE: PCT has emerged as an alternative to MR imaging for the assessment of patients with suspected acute stroke. However, 1 disadvantage of PCT is its limited anatomic coverage, which may impact the characterization of hemispheric ischemic strokes. The purpose of this study was to determine the optimal brain CT coverage required to accurately estimate the size of the infarct core relative to the MCA territory and the infarct-penumbra mismatch, by using a criterion standard of these parameters measured on PCT with 80-mm z-axis coverage.

MATERIALS AND METHODS: Fifty-one patients with acute ischemic hemispheric stroke underwent PCT scanning (2 boluses, total coverage of 80 mm, 16 × 5 mm sections) within the first 24 hours of symptom onset and a follow-up NCCT of the brain between 3 days and 3 months after the initial stroke CT study. The volumes of PCT infarct and penumbra for each possible extent of z-axis coverage derived from the individual PCT sections were recorded (beginning with 5 mm of z-axis coverage above the orbits and then increasing the coverage in 5-mm increments in the z-axis up to 80 mm above the orbits). The infarct-penumbra mismatch and the size of the infarction relative to the MCA territory were calculated for each extent of z-axis coverage. Using the 80-mm z-axis coverage as the criterion standard, we calculated the accuracy of the values of the relative PCT infarct size and mismatch that were obtained by using more limited z-axis coverage. The impact of different levels of PCT z-axis coverage on the eligibility for reperfusion treatment was assessed.

RESULTS: On the admission PCT, by using 80-mm of z-axis coverage, the mean perfusion infarct core volume was 45.9 ± 44.0 cm3 (range, 0–170 cm3) and the mean penumbra volume was 64.5 ± 64.4 cm3 (range, 0–226 cm3). The mean perfusion infarct core/MCA territory ratio was 19.6% ± 16.2% (range, 0.1%–56%). The penumbra / (infarct + penumbra) ratio was 68.6% ± 23.6% (range, 16.4%–100%). The final infarct volume on follow-up NCCT was 115.4 ± 157.3 cm3 (range, 1.79–647.4 cm3). The minimal z-axis PCT coverage required to obtain values similar to those obtained with 80-mm z-axis coverage was 75 mm for a mismatch of 0.5, fifty millimeters for a mismatch of 0.2, and 55 mm for a size of PCT infarct relative to the MCA territory.

CONCLUSIONS: Seventy-five millimeters is the minimal PCT coverage required to use PCT as a tool to select patients with acute stroke for reperfusion therapy by using a mismatch of 0.5. A z-axis coverage of 50 mm was sufficient for a mismatch of 0.2; and 55 mm, for the size of PCT infarct relative to MCA territory (one-third or more).

Abbreviations

ATLANTIS
Alteplase ThromboLysis for Acute Noninterventional Therapy in Ischemic Stroke
ASPECTS
Alberta Stroke Program Early CT Score
CBV
cerebral blood volume
CTA
CT angiography
DWI
diffusion-weighted imaging
FU
follow-up
kV(p)
kilovolt (peak)
MCA
middle cerebral artery
MTT
mean transit time
NCCT
noncontrast CT
p50
50th percentile
p95
95th percentile
p100
100th percentile
PCT
perfusion CT
PWI
perfusion-weighted imaging
  • Copyright © American Society of Neuroradiology

Indicates open access to non-subscribers at www.ajnr.org

View Full Text
PreviousNext
Back to top

In this issue

American Journal of Neuroradiology: 31 (4)
American Journal of Neuroradiology
Vol. 31, Issue 4
1 Apr 2010
  • Table of Contents
  • Index by author
Advertisement
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Optimal Brain Perfusion CT Coverage in Patients with Acute Middle Cerebral Artery Stroke
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Cite this article
A.D. Furtado, B.C. Lau, E. Vittinghoff, W.P. Dillon, W.S. Smith, T. Rigby, L. Boussel, M. Wintermark
Optimal Brain Perfusion CT Coverage in Patients with Acute Middle Cerebral Artery Stroke
American Journal of Neuroradiology Apr 2010, 31 (4) 691-695; DOI: 10.3174/ajnr.A1880

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
0 Responses
Respond to this article
Share
Bookmark this article
Optimal Brain Perfusion CT Coverage in Patients with Acute Middle Cerebral Artery Stroke
A.D. Furtado, B.C. Lau, E. Vittinghoff, W.P. Dillon, W.S. Smith, T. Rigby, L. Boussel, M. Wintermark
American Journal of Neuroradiology Apr 2010, 31 (4) 691-695; DOI: 10.3174/ajnr.A1880
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Purchase

Jump to section

  • Article
    • Abstract
    • Abbreviations
    • Materials and Methods
    • Results
    • Discussion
    • Conclusions
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • Responses
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Radiation Doses of Cerebral Blood Volume Measurements Using C-Arm CT: A Phantom Study
  • Crossref
  • Google Scholar

This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.

More in this TOC Section

  • Evaluating the Effects of White Matter Multiple Sclerosis Lesions on the Volume Estimation of 6 Brain Tissue Segmentation Methods
  • Quiet PROPELLER MRI Techniques Match the Quality of Conventional PROPELLER Brain Imaging Techniques
  • Predictors of Reperfusion in Patients with Acute Ischemic Stroke
Show more Brain

Similar Articles

Advertisement

Indexed Content

  • Current Issue
  • Accepted Manuscripts
  • Article Preview
  • Past Issues
  • Editorials
  • Editor's Choice
  • Fellows' Journal Club
  • Letters to the Editor
  • Video Articles

Cases

  • Case Collection
  • Archive - Case of the Week
  • Archive - Case of the Month
  • Archive - Classic Case

More from AJNR

  • Trainee Corner
  • Imaging Protocols
  • MRI Safety Corner
  • Book Reviews

Multimedia

  • AJNR Podcasts
  • AJNR Scantastics

Resources

  • Turnaround Time
  • Submit a Manuscript
  • Submit a Video Article
  • Submit an eLetter to the Editor/Response
  • Manuscript Submission Guidelines
  • Statistical Tips
  • Fast Publishing of Accepted Manuscripts
  • Graphical Abstract Preparation
  • Imaging Protocol Submission
  • Evidence-Based Medicine Level Guide
  • Publishing Checklists
  • Author Policies
  • Become a Reviewer/Academy of Reviewers
  • News and Updates

About Us

  • About AJNR
  • Editorial Board
  • Editorial Board Alumni
  • Alerts
  • Permissions
  • Not an AJNR Subscriber? Join Now
  • Advertise with Us
  • Librarian Resources
  • Feedback
  • Terms and Conditions
  • AJNR Editorial Board Alumni

American Society of Neuroradiology

  • Not an ASNR Member? Join Now

© 2025 by the American Society of Neuroradiology All rights, including for text and data mining, AI training, and similar technologies, are reserved.
Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire