Neuroimaging applications of multislice CT perfusion

Abstract

In acute stroke, very early cranial CT may be normal. Perfusion CT shows great promise in refining the selection of patients suitable for thrombolysis, as it can accurately determine infarct core from potentially salvageable ischaemic penumbra.In patients with acute subarachnoid haemorrhage, perfusion abnormalities are evident early on and can predict subsequent vasospasm. These can be detected by CT perfusion, which may enable more aggressive medical management of vasospasm.Some cerebral tumours are associated with angiogenesis and a breakdown of the blood-brain barrier. Angiogenesis can be detected as an increase in flow and volume parameters, and blood-brain barrier breakdown can be quantified as contrast accumulates in the interstitial space. Such aggressive features can distinguish malignant from benign tumours when standard imaging may not.CT perfusion is a very promising tool, and new advances in the technique are overcoming some of the initial shortcomings, leading to increased coverage, reduced p...