American Journal of Neuroradiology 23:1013-1021, June-July 2002
© 2002 American Society of Neuroradiology
BRAIN
Functional CT Perfusion Imaging in Predicting the Extent of Cerebral Infarction from a 3-Hour Middle Cerebral Arterial Occlusion in a Primate Stroke Model
a MGH Perfusion and Physiology Analysis Laboratory, the Massachusetts General Hospital and Harvard Medical School, Boston
b Department of Neuroradiology, the Massachusetts General Hospital and Harvard Medical School, Boston
c Department of Neurosurgery, the Massachusetts General Hospital and Harvard Medical School, Boston
Address reprint requests to: Leena M. Hamberg, PhD, DSc, Massachusetts General Hospital, MGH Perfusion and Physiology Analysis Laboratory, Gray B238, 55 Fruit St., Boston, MA 02114
BACKGROUND AND PURPOSE: Our purpose was to determine whether cerebral perfusion functional CT (fCT), performed after endovascular middle cerebral artery (MCA) occlusion, can be used to predict final cerebral infarction extent in a primate model.
METHODS: fCT with bolus tracking was performed before and 30 and 150 minutes after 3-hour digital subtraction angiography (DSA)–guided endovascular MCA occlusion in five baboons. Parametric cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) maps were constructed by voxel-by-voxel gamma variate fitting and used to determine lesion sizes. Animals were sacrificed 48 hours after the occlusion, and ex vivo MR imaging was performed. Lesion sizes on fCT and MR images were compared.
RESULTS: Hypoperfusion was clearly identified on all images obtained after MCA occlusion. Thirty and 150 minutes after occlusion onset, respectively, mean lesion sizes were 737 mm2 ± 33 and 737 mm2 ± 44 for CBF, 722 mm2 ± 32 and 730 mm2 ± 43 for CBV, and 819 mm2 ± 14 and 847 mm2 ± 11 for MTT. Mean outcome infarct size on MR images was 733 mm2 ± 30. Measurements based on CBV and CBF (R2 = 0.97 and 0.96, P < .001), but not MTT (R2 = 0.40, P > .5), were highly correlated with final lesion size.
CONCLUSION: An endovascular approach to MCA occlusion provides a minimally invasive, reproducible animal model for controlled studies of cerebral ischemia and infarction. Derived cerebral perfusion maps closely predict the 48-hour infarct size after 3-hour MCA occlusion.
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