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AJNR - American Journal of Neuroradiology

Published ahead of print on March 6, 2009
doi: 10.3174/ajnr.A1487

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Theoretic Basis and Technical Implementations of CT Perfusion in Acute Ischemic Stroke, Part 1: Theoretic Basis

A.A. Konstas^a, G.V. Goldmakher^a, T.-Y. Lee^b and M.H. Lev^a

^a Department of Radiology, Massachusetts General Hospital, Boston, Mass
^b Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada

View larger version (69K): [in this window] [in a new window]   Fig 1. CT perfusion images obtained in a patient with acute ischemic stroke demonstrate a large perfusion defect in the left MCA distribution, with minimal CBV/MTT or CBF mismatch. A, CBF. B, CBV. C, MTT.

View larger version (25K): [in this window] [in a new window]   Fig 2. CTA source images acquired during a steady state of contrast concentration for both the arterial and tissue–time-attenuation curves (T) are predominantly blood-volume– rather than blood-flow–weighted. The change in attenuation due to iodine administration is directly proportional to its concentration. CBV equals the ratio of the areas under the 2 curves, Ctissue and Carterial, respectively. This can be approximated as the ratio of the HUtissue/HUarterial when the 2 curves approach steady state.

View larger version (20K): [in this window] [in a new window]   Fig 3. Fick Principle.