Document Detail


Qualitative aspects of cranial CT perfusion scanning in a mixed neurosurgical patient collective.
MedLine Citation:
PMID:  19388325     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In patients with ischemic stroke, computer tomography (CT) perfusion imaging provides rapid information on the penumbra adjacent to the infarct core. For neurosurgical patients with acute brain injury, the value of CT perfusion is undecided up to now. We present our experience in a series of 78 examinations in 35 patients with acute intracranial pathology. METHODS: CT perfusion was performed with a Siemens Emotion Duo CT scanner using a single slice at the level of the upper basal ganglia. Color maps of time to peak (TTP), cerebral blood flow (CBF) and cerebral blood volume (CBV) were analyzed according to qualitative criteria. Quantitative evaluation with self-defined regions of interest was not performed due to repeatability problems and inconsistent data. FINDINGS: TTP showed an interhemispheric difference in 45% and regional prolongation in 16% of the scans. Global TTP was prolonged in 60%, while global CBF was reduced in 43%. Two patients showed hyperemia. A CBF/CBV mismatch, indicating non-infarcted penumbra at risk, was seen in 67%. Six patients with aneurysmal SAH showed reduced CBF, and consecutive angiography confirmed vasospasm in every case. CONCLUSIONS: CT perfusion scanning gives valuable information at a low risk and with negligible additional time after a routine cranial CT. In our opinion, this modality may have considerable impact on the clinical management of severely brain injured patients in future.
Authors:
S Wolf; N Kuckertz; M Bauer; L Schürer; C Lumenta
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  102     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2008  
Date Detail:
Created Date:  2009-04-24     Completed Date:  2009-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  253-7     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Academic Hospital Munich-Bogenhausen, Technical University of Munich, Englschalkinger Strasse 77, 81925 München, Germany. Stefan.Wolf@operamail.com
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity
Brain / metabolism,  pathology,  physiopathology
Brain Ischemia / physiopathology,  radiography*
Brain Mapping*
Cerebrovascular Circulation / physiology
Female
Humans
Male
Perfusion / methods
Regional Blood Flow
Skull / radiography
Time Factors
Tomography, X-Ray Computed / methods*
Vasospasm, Intracranial / etiology,  radiography

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