Theoretic Basis and Technical Implementations of CT Perfusion in Acute Ischemic Stroke, Part 1: Theoretic Basis

A.A Konstas,G.V Goldmakher,M.H Lev,T.-Y Lee

doi:10.3174/ajnr.a1487

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.

Highlights

Part 1 of this review establishes the clinical context of CT perfusion (CTP)
Brain-tissue flow can be described by several parameters, including cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) (Fig 1)
CBV Calculations The dynamic first-pass approach to CTP measurement involves the intravenous administration of an intravascular contrast agent, which is tracked with serial imaging during its first circulation through the brain tissue capillary bed

Summary

Introduction

Part 1 of this review establishes the clinical context of CT perfusion (CTP). a discussion follows on CTP map construction by using the maximal slope method and the 2 main deconvolution techniques, Fourier transformation (FT) and singular value decomposition (the latter being the most commonly used numeric method in CTP). Brain-tissue flow can be described by several parameters, including CBF, CBV, and mean transit time (MTT) (Fig 1).

Results

Conclusion