Academic Radiology
Volume 17, Issue 4 , Pages 427-432, April 2010

Whole Brain Perfused Blood Volume CT:

Visualization of Infarcted Tissue Compared to Quantitative Perfusion CT

  • Gunnar Wittkamp, Cand Med

      Affiliations

    • Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Str. 33, 48149 Muenster, Germany
    • ,
  • Boris Buerke, MD

      Affiliations

    • Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Str. 33, 48149 Muenster, Germany
    • ,
  • Rainer Dziewas, MD

      Affiliations

    • Department of Neurology, University of Muenster, Muenster, Germany
    • ,
  • Hendrik Ditt, Dipl Phys

      Affiliations

    • Siemens AG, Healthcare Sector, Forchheim, Germany
    • ,
  • Peter Seidensticker, MD

      Affiliations

    • Bayer Schering Pharma AG, BU Diagnostic Imaging, Berlin, Germany
    • ,
  • Walter Heindel, MD

      Affiliations

    • Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Str. 33, 48149 Muenster, Germany
    • ,
  • Stephan P. Kloska, MD

      Affiliations

    • Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Str. 33, 48149 Muenster, Germany
    • Corresponding Author InformationAddress correspondence to: S.P.K.

Received 9 September 2009; accepted 3 November 2009. published online 11 January 2010.

Rationale and Objectives

This study determines the value of whole brain color-coded three-dimensional perfused blood volume (PBV) computed tomography (CT) for the visualization of the infarcted tissue in acute stroke patients.

Materials and Methods

Nonenhanced CT (NECT), perfusion CT (PCT), and CT angiography (CTA) in 48 patients with acute ischemic stroke were performed. Whole brain PBV was calculated from NECT and CTA data sets using commercial software. PBV slices in identical orientation to the PCT slices were reconstructed and the area of visual perfusion abnormality on PBV maps was measured. The infarct core in the corresponding PCT slices (CBV <2.0 mL/100 g) was measured automatically with commercial software. The ischemic area on PBV and the infarct core on quantitative PCT were compared using the Pearsons-R correlation coefficient. Significance was considered for P < .05.

Results

The quantitative PCT demonstrated a mean infarct core volume of 35.48 ± 32.17 cm3, whereas the volume of visual perfusion abnormality of the corresponding PBV slices was 37.16 ± 37.59 cm3. The perfusion abnormality in PBV was highly correlated with the infarct core of quantitative PCT for area per slice (r = 0.933, P < .01) as well as volume (r = 0.922, P < .01).

Conclusions

PBV can serve as surrogate marker corresponding to the infarct core in acute stroke with whole brain coverage.

Key Words: Perfused blood volume, cerebral blood volume, computed tomography, cerebral ischemia

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 Supported in part by a grant from Bayer Schering Pharma AG, Berlin, Germany.

 H.D. is employee of Siemens AG, Healthcare Sector, Forchheim, Germany. He has developed the used perfused blood volume software. P.S. is employee of Bayer Schering Pharma AG, Berlin, Germany. The other authors neither have any financial conflict with the manufacturer of the used equipment nor were otherwise biased in their scientific work.

 The study design, collection, analysis, and interpretation of the data, as well as the writing of the report were exclusive responsibilities of the authors. In particular, the sponsoring company (Bayer Schering Pharma AG, Berlin, Germany) had neither influence on the preparation of this report nor the decision to submit it for publication. The corresponding author had full access to the data of this study at any time and is finally responsible for the decision to submit for publication.

PII: S1076-6332(09)00630-8

doi:10.1016/j.acra.2009.11.005

Academic Radiology
Volume 17, Issue 4 , Pages 427-432, April 2010

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