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Advantages of Extended Brain Perfusion Computed Tomography 9.6 cm Coverage With Time Resolved Computed Tomography-Angiography in Comparison to Standard Stroke-Computed Tomography

Advantages of Extended Brain Perfusion Computed Tomography 9.6 cm Coverage With Time Resolved Computed Tomography-Angiography in Comparison to Standard Stroke-Computed Tomography INVESTIGATIVE RADIOLOGY Morhard, D., Wirth, C. D., Fesl, G., Schmidt, C., Reiser, M. F., Becker, C. R., Ertl-Wagner, B. 2010; 45 (7): 363-369

Abstract

Recent technical developments have led to an extension of perfusion computed tomography (PCT) scan range to cover nearly the entire brain and to reconstruct time resolved (4d) CT-angiography (CTA) datasets from the PCT data. The purpose of this study was to compare the results of simulated standard PCT and extended PCT with 4d-CTA.Extended multimodal stroke CT (unenhanced cranial CT, CTA, and PCT) was acquired in 72 patients. PCT images with a scan coverage of 9.6 cm in the z-axis, simulated 2 cm PCT images at the level of the basal ganglia comparable to standard PCT, standard supra-aortic CTA, and 4d-CTA images were reconstructed. Two readers assessed the PCT image quality as well as pathologic findings in extended and simulated PCT, CTA, and 4d-CTA. The brain was divided into 4 axial segments. The independent samples t test was applied to test differences between data for significance.In 75.0% of all patient exams, pathologic findings were observed in the PCT; these were located in 138 brain segments. In 24.1% of all 54 exams with pathologic PCT findings, the pathology would have been missed on standard PCT. The longer scan coverage resulted in a different final diagnosis in 34.7% of all exams. Quality of the PCT parameter maps was on average very good both for the supratentoric and the infratentoric brain areas (4.28 and 4.18, respectively, on a 5-point scale). In 90% of all exams with pathologic changes in the CTA, these abnormalities were also noted on 4d-CTA. In only 2.8% of all cases, the additional time resolution of the 4d-CTA provided additional information.Extending the scan coverage of PCT from 2 cm to 9.6 cm led to an augmentation of clinically important information in the imaging of acute stroke.

View details for DOI 10.1097/RLI.0b013e3181e1956f

View details for Web of Science ID 000279394300001

View details for PubMedID 20458248