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Perfusion CT of the brain using 40-mm-wide detector and toggling table technique for initial imaging of acute stroke

Cited 35 time in Web of Science Cited 43 time in Scopus
Authors
Youn, Sung Won; Kim, Jae Hyoung; Weon, Young-Cheol; Kim, Sung Hyun; Han, Moon-Ku; Bae, Hee-Joon
Issue Date
2008-08-22
Publisher
American Roentgen Ray Society
Citation
AJR 2008; 191(3):W120-W126
Keywords
Acute DiseaseAdultAgedAged, 80 and overBrain/*radiographyBrain Ischemia/*radiographyFemaleHumansMaleMiddle AgedPerfusion/methodsRadiographic Image Enhancement/*instrumentation/methodsReproducibility of ResultsSensitivity and SpecificityStroke/*radiographyTomography, X-Ray Computed/*instrumentation/methods*Transducers
Abstract
OBJECTIVE: Limited coverage of the brain in the z-axis has been a drawback of perfusion CT. The purpose of this study was to evaluate the usefulness of perfusion CT with extended coverage in the z-axis for the assessment of acute stroke in an emergent clinical setting. MATERIALS AND METHODS: Fifty-eight patients who underwent 80-mm-coverage perfusion CT within 24 hours after stroke onset were included. Perfusion CT was performed using a 64-MDCT unit equipped with 40-mm-wide detector and the toggling table technique. Lesion detection by perfusion CT was analyzed using follow-up diffusion-weighted imaging and MR angiography as the reference standards. More conventional 20-mm-coverage perfusion CT was simulated by extracting data obtained at the basal ganglia level for comparison with 80-mm-coverage perfusion CT. RESULTS: Fifty-one patients had acute infarctions and seven patients did not. For 80-mm-coverage perfusion CT, perfusion abnormality was detected in 42 of 51 patients (sensitivity, 82.4%; and specificity, 85.7%). When patients with small artery disease (small acute infarctions in the basal ganglia, thalamus, corona radiata, and pons) were excluded, sensitivity increased to 92.3%. As compared with 80-mm-coverage perfusion CT, 20-mm-coverage perfusion CT missed nine acute infarctions located above or below the level of the basal ganglia (p = 0.0039). CONCLUSION: Perfusion CT with 80-mm-coverage was found to be useful as an initial imaging method in acute ischemic stroke, although it had low sensitivity for detecting small acute infarctions. In particular, this technique provided higher lesion detection than 20-mm-coverage perfusion CT.
ISSN
1546-3141 (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18716079

http://www.ajronline.org/cgi/reprint/191/3/W120.pdf

http://hdl.handle.net/10371/68451
DOI
https://doi.org/10.2214/AJR.07.2519
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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