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CT perfusion in acute stroke: Know the mimics, potential pitfalls, artifacts, and technical errors

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Abstract

The CT perfusion (CTP) imaging of brain has been established as a clinically useful tool in multimodality imaging of acute stroke. All abnormalities seen on perfusion CT are not specifically related to acute infarct. There are many neurologic diseases causing symptoms simulating cerebrovascular disease produce an alteration of brain perfusion and thus can result in perfusion CT abnormalities. There are many pitfalls and artifacts in acquiring the data, calculation of maps and choosing arterial input function. We analyze and classify all these aspects, to allow the technician and the radiologist to know exactly what to avoid and what to choose, and we indicate the way to improve the quality of examination. The knowledge of mimics and pitfalls in acute stroke imaging can be helpful in accurate interpretation of these examinations.

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Abbreviations

CT:

Computed tomography

CTP:

CT perfusion

CBV:

Cerebral blood volume

MTT:

Mean transit time

CBF:

Cerebral blood flow

ACA:

Anterior cerebral artery

MCA:

Middle cerebral artery

DWI:

Diffusion-weighted imaging

ICA:

Internal carotid artery

NCCT:

Noncontrast CT

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Acknowledgement

The authors are grateful to Sarah Peangatelli, Radiology Graphics Imaging Specialist for providing assistant with images.

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The authors declare that they have no conflict of interest.

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Correspondence to Rajiv Mangla.

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Mangla, R., Ekhom, S., Jahromi, B.S. et al. CT perfusion in acute stroke: Know the mimics, potential pitfalls, artifacts, and technical errors. Emerg Radiol 21, 49–65 (2014). https://doi.org/10.1007/s10140-013-1125-9

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  • DOI: https://doi.org/10.1007/s10140-013-1125-9

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