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Research ArticleBrainE

Flat Detector CT in the Evaluation of Brain Parenchyma, Intracranial Vasculature, and Cerebral Blood Volume: A Pilot Study in Patients with Acute Symptoms of Cerebral Ischemia

T. Struffert, Y. Deuerling-Zheng, S. Kloska, T. Engelhorn, C.M. Strother, W.A. Kalender, M. Köhrmann, S. Schwab and A. Doerfler
American Journal of Neuroradiology September 2010, 31 (8) 1462-1469; DOI: https://doi.org/10.3174/ajnr.A2083
T. Struffert
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Y. Deuerling-Zheng
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S. Kloska
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T. Engelhorn
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C.M. Strother
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W.A. Kalender
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M. Köhrmann
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S. Schwab
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A. Doerfler
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  • Fig 1.
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    Fig 1.

    A, Regions of interest for CBV measurements: 1) lateral basal ganglia; 2) frontal subcortical white matter; 3) occipital subcortical white matter; 4) thalamus; 5) corona radiata; 6) internal capsule, posterior limb. B, Bland-Altman plot displays slightly higher FD-CBV values (0.04 mL/100 mL) in comparison with CTP. C, Mean CBV values and SDs of the 6 regions of interest show only minimal deviations.

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    Fig 2.

    CT (A) and FD-CT (B) show the good correlation of CBV color maps. CTA (C) and FD-CTA (D) display a high-grade stenosis (black arrows) of the left MCA (patient 4). Note the perfect delineation of this high-grade stenosis in FD-CTA.

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    Fig 3.

    A, At initial scanning, the brain appears without any signs of stroke. B, FD-CT performed 24 hours later cannot visualize the stroke region. C, MR imaging also performed 24 hours later confirms infarct demarcation (arrows). D−F, MIP reconstruction of the CTA (D) and FD-CTA (E) corresponds perfectly with the DSA finding (F) of stenosis (arrow) in the distal M1 as well as the proximal M2 segments. Notice the sharp delineation of the vessels in FD-CTA in contrast to that in CTA.

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    Fig 4.

    A and B, Comparison of CTP-CBV (A) with FD-CBV (B) demonstrates decrease of CBV in the region of the internal capsule, anterior limb. C, The region matches nicely with the MR image (Fig 3C).

Tables

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  • Summary of clinical and imaging characteristics

    No.Age (yr)Vascular PathologySymptomsTreatmentCBV LesionFD-CT CBVCTP-CBVEvans IndexStenosis Grade (%)Interval, CT to FD-CT (hr)
    FD-CTMSCTFD-CTMSCTDSA
    181VA stenosis, rightTIAMedical0.270.2867667220.5
    270Extracranial ICA stenosisTIACarotid stenting0.260.2517.75
    376MCA occlusion, leftMinor strokeMedicalInternal capsule, anterior limb2.6 mL/100 mL2.7 mL/100 mL0.310.3218
    461MCA stenosis, leftTIAStent0.420.4394929516.5
    561VA stenosis, leftTIAMedical0.370.3682788018.5
    669VA stenosis, rightTIAMedical0.30.3188858413.5
    750MCA stenosis, rightMinor strokeStentInternal capsule, nterior limb2.1 mL/100 mL1.8 mL/100 mL0.250.2680817613.75
    852MCA occlusion, rightMinor strokeMedicalTemporal lobe1.6 mL/100 mLNot visible0.210.2216.25
    967MCA aneurysmTIAMedical0.280.2714.5
    1067Carotid aneurysmTIAMedical0.240.2521.5
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American Journal of Neuroradiology: 31 (8)
American Journal of Neuroradiology
Vol. 31, Issue 8
1 Sep 2010
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Flat Detector CT in the Evaluation of Brain Parenchyma, Intracranial Vasculature, and Cerebral Blood Volume: A Pilot Study in Patients with Acute Symptoms of Cerebral Ischemia
T. Struffert, Y. Deuerling-Zheng, S. Kloska, T. Engelhorn, C.M. Strother, W.A. Kalender, M. Köhrmann, S. Schwab, A. Doerfler
American Journal of Neuroradiology Sep 2010, 31 (8) 1462-1469; DOI: 10.3174/ajnr.A2083

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Flat Detector CT in the Evaluation of Brain Parenchyma, Intracranial Vasculature, and Cerebral Blood Volume: A Pilot Study in Patients with Acute Symptoms of Cerebral Ischemia
T. Struffert, Y. Deuerling-Zheng, S. Kloska, T. Engelhorn, C.M. Strother, W.A. Kalender, M. Köhrmann, S. Schwab, A. Doerfler
American Journal of Neuroradiology Sep 2010, 31 (8) 1462-1469; DOI: 10.3174/ajnr.A2083
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