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 established the clinical context of CT perfusion (CTP).[1]
A discussion followed on CTP map construction using the maximum slope method and the 2 main deconvolution techniques, Fourier transformation and singular value decomposition (SVD)
The review highlights the need for validation and standardization of important CTP parameters to improve patient outcomes and design future randomized clinical trials that will provide evidence for the importance of the core/ penumbra “mismatch” in patient triage for recanalization therapies beyond the current 3-hour therapeutic window for intravenous thrombolysis
Summary
Theoretic Basis and Technical Implementations of CT Perfusion in Acute Ischemic Stroke, Part 2: Technical Implementations. SUMMARY: 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. The review highlights the need for validation and standardization of important CTP parameters to improve patient outcomes and design future randomized clinical trials that will provide evidence for the importance of the core/ penumbra “mismatch” in patient triage for recanalization therapies beyond the current 3-hour therapeutic window for intravenous thrombolysis
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