Abstract
CTP has a growing role in evaluating stroke. It can be performed immediately following NCCT and has advantages of accessibility and speed. Differentiation of salvageable ischemic penumbra from unsalvageable core infarct may help identify patients most likely to benefit from thrombectomy or thrombolysis. Still, CTP interpretation can be complex. We review normal and ischemic perfusion patterns followed by an illustrative series of technical/diagnostic challenges of CTP interpretation in the setting of acute stroke syndromes.
Highlights
SUMMARY: CTP has a growing role in evaluating stroke
Visual inspection of CTP color maps can be an effective way of identifying areas of core infarct and penumbra and may be sufficient to guide decisions on intervention.[8,9]
Applied to CTP, ASPECTS scoring of parametric maps has been shown to improve identification of early ischemic changes and predict infarct extent and outcome of thrombolysis compared with NCCT alone.[41,42,43,44]
Summary
Evaluation of CT Perfusion in the Setting of Cerebral Ischemia: Patterns and Pitfalls. SUMMARY: CTP has a growing role in evaluating stroke It can be performed immediately following NCCT and has advantages of accessibility and speed. We review normal and ischemic perfusion patterns followed by an illustrative series of technical/diagnostic challenges of CTP interpretation in the setting of acute stroke syndromes. The role of CTP in the acute stroke setting continues to grow despite widespread use of DWI.[9] CT has distinct advantages, including relative cost, availability, and ease of patient monitoring.[10] The advent of multidetector CT has increased imaging speed, making dynamic and angiographic imaging possible. As the role of CTP grows in the diagnosis and treatment of acute stroke, it becomes ever more important for the radiologist to understand patterns and potential pitfalls in interpretation. We review a series of perfusion patterns with illustrative cases of cerebral ischemia and mimickers
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