Correlation of Early Dynamic CT Perfusion Imaging with Whole-Brain MR Diffusion and Perfusion Imaging in Acute Hemispheric Stroke
James D. Eastwooda,
Michael H. Levd,
Max Wintermarke,
Clemens Fitzekf,
Daniel P. Barboriaka,
David M. Delongb,
Ting-Yim Leeg,
Tarek Azharif,
Michael Herzauf,
Vani R. Chilukuric and
James M. Provenzalea
a Department of Radiology, Duke University Medical Center, Durham, NC
b Department of Community and Family Medicine, Duke University Medical Center, Durham, NC
c Department of Medicine, Division of Neurology, Duke University Medical Center, Durham, NC
d Division of Neuroradiology, Massachusetts General Hospital, Boston, University Hospital, Lausanne, Switzerland
e Department of Diagnostic and Interventional Radiology, University Hospital, Lausanne, Switzerland
f Department of Diagnostic and Interventional Radiology, Friedrich-Schiller University, Jena, Germany
g Imaging Research Laboratories, John P. Robarts Research Institute, London, Ontario, Canada
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FIG 1. 54-year-old man with right hemiparesis.
A–D, Diffusion-weighted images (b = 1000 s/mm2) illustrate volume of abnormality. Three-dimensional volume of abnormality was found by summing the areas of abnormality on each section (arrows) and multiplying by section thickness. The same approach was used to compute volumes of MR perfusion abnormality.
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FIG 2. Scatterplot compares extents of CBF abnormality on single-slice CT perfusion scans with their corresponding extent of CBF abnormality on multislice MR perfusion images. Kendall  b correlation coefficient for comparison of extent of CT-CBF with extent of MR-CBF was 0.60 (P = .003).
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FIG 3. 90-year-old woman with acute right hemiparesis and aphasia 2 hours before imaging.
A, CT perfusion CBV map shows well-circumscribed area of very low CBV (arrows).
B, MR perfusion CBV map. Correlation of volume of MR-CBV abnormality with area of CT-CBV abnormality approached statistical significance in our study.
C, CT perfusion CBF map shows a larger abnormality than seen on the CBV map. CBF in the range of 0–10 mL/100 g/min is displayed as blue (arrows).
D, MR perfusion CBF map with areas of low relative CBF (< 50%) displayed as blue (arrows). Good correlation was found in our study between extents of 2D CT-CBF abnormality and 3D MR-CBF abnormality.
E, CT perfusion MTT map shows the largest extent of abnormality. Values of MTT greater than 6 seconds are displayed as red (arrows).
F, MR MTT map. Good correlation was found in our study between 2D CT-MTT abnormalities and 3D MR-MTT abnormalities (arrows).
G, Diffusion-weighted MR image (b = 1000 s/mm2) obtained 4 hours after symptom onset through the basal ganglia shows abnormality in the left frontal lobe (arrows). Good correlation was found in our study between extent of CT-CBV abnormality and extent of diffusion-weighted abnormality. Good correlation was also found with extents of MR-CBV and MR-MTT abnormalities.
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