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Review
. 2009 Apr;30(4):662-8.
doi: 10.3174/ajnr.A1487. Epub 2009 Mar 6.

Theoretic basis and technical implementations of CT perfusion in acute ischemic stroke, part 1: Theoretic basis

A A Konstas  1 , G V Goldmakher, T-Y Lee, M H Lev
Affiliations
Review

Theoretic basis and technical implementations of CT perfusion in acute ischemic stroke, part 1: Theoretic basis

A A Konstas et al. AJNR Am J Neuroradiol. 2009 Apr.

Abstract

CT perfusion (CTP) is a functional imaging technique that provides important information about capillary-level hemodynamics of the brain parenchyma and is a natural complement to the strengths of unenhanced CT and CT angiography in the evaluation of acute stroke, vasospasm, and other neurovascular disorders. CTP is critical in determining the extent of irreversibly infarcted brain tissue (infarct "core") and the severely ischemic but potentially salvageable tissue ("penumbra"). This is achieved by generating parametric maps of cerebral blood flow, cerebral blood volume, and mean transit time.

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Figures

Fig 1.
Fig 1.
CT perfusion images obtained in a patient with acute ischemic stroke demonstrate a large perfusion defect in the left MCA distribution, with minimal CBV/MTT or CBF mismatch. A, CBF. B, CBV. C, MTT.
Fig 2.
Fig 2.
CTA source images acquired during a steady state of contrast concentration for both the arterial and tissue−time-attenuation curves (ΔT) are predominantly blood-volume− rather than blood-flow−weighted. The change in attenuation due to iodine administration is directly proportional to its concentration. CBV equals the ratio of the areas under the 2 curves, Ctissue and Carterial, respectively. This can be approximated as the ratio of the HUtissue/HUarterial when the 2 curves approach steady state.
Fig 3.
Fig 3.
Fick Principle.
See this image and copyright information in PMC

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