Sotirios Bisdas MD, Presenter: Nothing to Disclose

Frank Donnerstag, Abstract Co-Author: Nothing to Disclose

Bjorn Ahl, Abstract Co-Author: Nothing to Disclose

Karin Weissenborn, Abstract Co-Author: Nothing to Disclose

Hartmut Becker MD, Abstract Co-Author: Nothing to Disclose

The identification of the ischemic tissue in hyperacute stroke (including delineation of penumbra and infarcted area), and the possible predictive values of the derived perfusion- and diffusion parameters remain challenging in stroke patients. In this study, we compared perfusion CT and diffusion-weighted MRI (DWI) as means of assessing the ischemic brain in hyperacute stroke.

In 18 patients with ischemic stroke <3 hours after onset, perfusion CT was used to measure the ischemic lesion (penumbra plus infarct), penumbra and infarct, and calculate cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) values in these areas. The volume of the hypoperfused areas was compared with that of the MR abnormalities as shown on the DWI trace. Both lesion volumes were correlated with the findings on follow-up CT and MRI studies as well as with the admission and follow-up clinical NIHSS scores.

The volume of the ischemic tissue on the perfusion CT was strongly correlated with the volume of the diffusion abnormalities on admission MRI (r=.89, P=.001). The volume of the infarcted tissue correlated stronger (r2=.82, P=.0001) than the diffusion abnormality volume (r2=.69, P=.002) with the follow-up infarct volume. Statistically significant correlations were found between ischemic and infarct region volumes and NIHSS admission score (P=.01). Furthermore, ischemic volume on perfusion CT and follow-up NIHSS score were also significantly correlated (r=.62, P=.009).

Both imaging modalities provide a rapid and sufficient assessment of the hyperacute brain infarct with significant correlation between them and the admission clinical condition. It remains on perfusion CT a differentiation of penumbra and infarct core region with significant predictive value of follow-up infarct volume and clinical outcome.

Bisdas, S, Donnerstag, F, Ahl, B, Weissenborn, K, Becker, H, Comparison of Perfusion Computed Tomography with Diffusion-weighted Magnetic Resonance Imaging in Hyperacute Ischemic Stroke.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4405887.html