Christian Grieser, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: Aim was to determine if CT-based perfusion mapping improves the sensitivity for detecting early cerebral ischemia beyond that of unenhanced cranial CT Methods and Materials: A total of 76 patients (age 50-90, mean: 70 years) were examined using multirow CT (8 row multidetector, LightSpeed Ultra, GEMS, MilwaukeeWI) for suspected acute cerebral ischaemia. Initially, unehanced cranial CT images were aquired. Then, a dynamic perfusion series was acquired over a 60 s period using a 40 cc contrast bolus (Iopromide, 370 mg Iodine/cc, Schering, Berlin, Germany). Z-axis coverage was 20 mm. Regional blood flow and Mean Transit Time (MTT) were determined on a clinical workstation using standard software (Perfusion 2, Advantage Windows V4.01, GEMS, Milwaukee, WI). Results: All areas of ischaemia visible on unenhanced CT were also identified by perfusion mapping. The areas revealed reduced blood flow and prolonged MTT (100%). In addition, areas of acute cerebral ischemia were discovered by perfusion analysis only in 10 patients (7,6%) but remained undiscernible upon review of the non-contrast-enhanced CT series. Perfusion analysis detected 26 instances of cerebral ischemia in our 76 patients (34%), whereas the unenhanced CT detected only 16 (21%). Thus, the unenhanced series detected only 16/26 instances of acute cerebrl ischemia detected by CT-perfusioon mapping (62%), while 10/26 (38%) remained undetected. Conclusion: CT perfusion mapping detects areas of acute cerebral ischemia in a significant proportion of stroke patients with normal non-contrast cranial CT. Thus, early diagnosis of ischemic brain injury may be improved, and the therapeutic strategy adjusted accordingly       Questions about this event email: grieser@web.de

Grieser, C, Detection of Cerebral Ischemia Using Computed Tomography Perfusion Mapping.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3105201.html