Perfusion CT and acute stroke imaging: foundations, applications, and literature review

Joseph Donahue; Max Wintermark

doi:10.1016/j.neurad.2014.11.003

Perfusion CT and acute stroke imaging: foundations, applications, and literature review

J Neuroradiol. 2015 Feb;42(1):21-9. doi: 10.1016/j.neurad.2014.11.003. Epub 2015 Jan 27.

Authors

Joseph Donahue¹, Max Wintermark²

Affiliations

¹ Division of Neuroradiology, University of Virginia, Charlottesville, VA, United States.
² Division of Neuroradiology, University of Virginia, Charlottesville, VA, United States; Department of Radiology, Division of Neuroradiology, Stanford University, 300, Pasteur Drive, Room S047, Stanford, CA 94305-5105, United States. Electronic address: max.wintermark@gmail.com.

PMID: 25636991
DOI: 10.1016/j.neurad.2014.11.003

Abstract

Multimodal CT features prominently in the rapidly evolving field of acute stroke triage, with perfusion CT applications at the forefront of many clinical research efforts. Perfusion CT offers a time sensitive and widely practicable assessment of cerebral hemodynamics and parenchymal viability that is key in acute stroke management. The following article reviews perfusion CT foundations and technical considerations while highlighting recent modality advances and frontline clinical applications. Ischemic penumbra and other prognostic imaging biomarkers are discussed in the context of results of recent clinical trials (MR-RESCUE, IMS III, Tenecteplase, etc.), with an emphasis on evidence based image guided stroke triage.

Keywords: Acute ischemic stroke imaging; Cerebrovascular accident; Cerebrovascular circulation; Perfusion imaging.

Publication types

Review

MeSH terms

Cerebral Angiography / methods*
Evidence-Based Medicine
Humans
Radiographic Image Enhancement / methods*
Reproducibility of Results
Sensitivity and Specificity
Stroke / diagnostic imaging*
Tomography, X-Ray Computed / methods*