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.


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*