Improving the impact of different input arteries on cerebral CT perfusion parameters and ischemic penumbra

Abstract

This study aims to examine the impact of different input arteries on cerebral perfusion parameters and the volume of core infarction, ischemic area, and penumbra automatically measured by software in post-processing 256-slice CT brain perfusion images. Retrospective analysis was conducted on brain perfusion images of 58 patients who underwent 256-slice multidetector CT examination for cerebral infarction. Various input arteries, including bilateral internal carotid artery (ICA), bilateral middle cerebral artery (MCA), anterior cerebral artery (ACA), and basilar artery (BA), were selected for image processing and measurements. The volumes of core infarction, ischemic area, and penumbra were automatically calculated using software. Additionally, manual measurements were per-formed by experienced doctors. Perfusion parameters including cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and time to peak (TTP) were evaluated. The change of input artery resulted in a significant difference in CBF and MTT in the penumbra and normal brain tissue areas. However, no significant difference was observed in CBV, TTP, and perfusion parameters in the core infarct area. The volumes of core infarction acquired from different input arteries showed no significant difference. Nonetheless, significant differences were found in the volume of the ischemic area and the mismatched area. The selection of different input arteries affects CT cerebral perfusion parameter values and the automatic measurement of the ischemic area and penumbra by software. Thus, when performing post-processing of CT cerebral perfusion images, it is advisable to choose the thicker internal carotid artery on the healthy side as the input artery.