First-Pass Quantitative CT Perfusion Identifies Thresholds for Salvageable Penumbra in Acute Stroke Patients Treated with Intra-arterial Therapy
P.W. Schaefer,
L. Roccatagliata,
C. Ledezma,
B. Hoh,
L.H. Schwamm,
W. Koroshetz,
R.G. Gonzalez and
M.H. Lev
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
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Fig 1. A 61-year-old male patient with right hemiparesis imaged at 2.3 hours and 3 days. Abnormal areas are outlined on CBV (A), CBF (B), and follow-up CT (C) images. After coregistration, we defined 3 regions on CBF maps (D): region 1 (red), "infarct core"—abnormal on CBV, CBF, and follow-up CT images; region 2 (blue), "penumbra that infarcts"—normal on CBV but abnormal on CBF and follow-up CT images; and region 3 (green) "penumbra that recovers"—abnormal on CBF but normal on CBV and follow-up CT images.
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Fig 2. Box and Whisker graphs of normalized CBV (A) and CBF ratios (B) in regions 1–3.
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Fig 3. Box and Whisker graphs of mean GM and WM quantitative CBF values for each patient in regions 2 and 3.
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