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Research ArticleBRAIN

Simultaneous Measurement of Regional Cerebral Blood Flow by Perfusion CT and Stable Xenon CT: A Validation Study

Max Wintermark, Jean-Philippe Thiran, Philippe Maeder, Pierre Schnyder and Reto Meuli
American Journal of Neuroradiology May 2001, 22 (5) 905-914;
Max Wintermark
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Jean-Philippe Thiran
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Philippe Maeder
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Pierre Schnyder
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Reto Meuli
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Abstract

BACKGROUND AND PURPOSE: Knowledge of cerebral blood flow (CBF) alterations in cases of acute stroke could be valuable in the early management of these cases. Among imaging techniques affording evaluation of cerebral perfusion, perfusion CT studies involve sequential acquisition of cerebral CT sections obtained in an axial mode during the IV administration of iodinated contrast material. They are thus very easy to perform in emergency settings. Perfusion CT values of CBF have proved to be accurate in animals, and perfusion CT affords plausible values in humans. The purpose of this study was to validate perfusion CT studies of CBF by comparison with the results provided by stable xenon CT, which have been reported to be accurate, and to evaluate acquisition and processing modalities of CT data, notably the possible deconvolution methods and the selection of the reference artery.

METHODS: Twelve stable xenon CT and perfusion CT cerebral examinations were performed within an interval of a few minutes in patients with various cerebrovascular diseases. CBF maps were obtained from perfusion CT data by deconvolution using singular value decomposition and least mean square methods. The CBF were compared with the stable xenon CT results in multiple regions of interest through linear regression analysis and bilateral t tests for matched variables.

RESULTS: Linear regression analysis showed good correlation between perfusion CT and stable xenon CT CBF values (singular value decomposition method: R2 = 0.79, slope = 0.87; least mean square method: R2 = 0.67, slope = 0.83). Bilateral t tests for matched variables did not identify a significant difference between the two imaging methods (P > .1). Both deconvolution methods were equivalent (P > .1). The choice of the reference artery is a major concern and has a strong influence on the final perfusion CT CBF map.

CONCLUSION: Perfusion CT studies of CBF achieved with adequate acquisition parameters and processing lead to accurate and reliable results.

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American Journal of Neuroradiology
Vol. 22, Issue 5
1 May 2001
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Simultaneous Measurement of Regional Cerebral Blood Flow by Perfusion CT and Stable Xenon CT: A Validation Study
Max Wintermark, Jean-Philippe Thiran, Philippe Maeder, Pierre Schnyder, Reto Meuli
American Journal of Neuroradiology May 2001, 22 (5) 905-914;

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Simultaneous Measurement of Regional Cerebral Blood Flow by Perfusion CT and Stable Xenon CT: A Validation Study
Max Wintermark, Jean-Philippe Thiran, Philippe Maeder, Pierre Schnyder, Reto Meuli
American Journal of Neuroradiology May 2001, 22 (5) 905-914;
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  • Guidelines for the Early Management of Patients With Ischemic Stroke: A Scientific Statement From the Stroke Council of the American Stroke Association
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  • Comparison of Admission Perfusion Computed Tomography and Qualitative Diffusion- and Perfusion-Weighted Magnetic Resonance Imaging in Acute Stroke Patients
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