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Brain perfusion CT: Principles, technique and clinical applications

La TC-perfusione dell’encefalo: principi, tecnica, applicazioni cliniche

  • Neuroradiology Neuroradiologia
  • Published:
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Abstract

The imaging of brain haemodynamics and its applications are generating growing interest. By providing quantitative measurements of cerebral blood flow (CBF) and cerebral blood volume (CBV), dynamic perfusion computed tomography (p-CT) allows visualisation of cerebral autoregulation mechanisms and represents a fast, available and reliable imaging option for assessing cerebral perfusion. Thanks to its feasibility in emergency settings, p-CT is considered most useful, in combination with CT angiography, in acute ischaemic patients, as it is able to provide a fast and noninvasive assessment of cerebral perfusion impairment. In addition, p-CT can play a diagnostic role in other types of cerebrovascular disease to assess functional reserve, and in intracranial neoplasms, where it has a role in diagnosis, grading, biopsy guidance, and follow-up during treatment. This article illustrates the principles, technique and clinical applications of p-CT cerebral perfusion studies.

Riassunto

Lo studio dell’emodinamica cerebrale, ottenuto con le metodiche di imaging, con le sue varie ed attuali applicazioni, genera interesse crescente. La TC perfusione dinamica (p-TC) permette una valutazione quantitativa del flusso cerebrale ematico (CBF) e del volume cerebrale ematico (CBV), offrendo così una visualizzazione diretta dei meccanismi di autoregolazione cerebrale, e si pone come una valida alternativa ad altre modalità di misurazione della perfusione cerebrale, rispetto alle quali ha il maggior vantaggio di essere una tecnica prontamente disponibile ed accessibile, in condizioni di emergenza, nella maggior parte dei centri medici. Per tale ragione la p-TC è utile soprattutto nell’ischemia cerebrale acuta, condizione in cui, associata all’angio-TC, offre in maniera rapida e non-invasiva, la valutazione eziologica dell’ipoperfusione, nonché delle sue ripercussioni emodinamiche e fisiopatologiche sul parenchima cerebrale. Inoltre la p-TC trova utile impiego in pazienti con altre patologie cerebro-vascolari e per la diagnosi, il grading, la guida alle procedure bioptiche, ed il controllo durante la terapia, dei tumori intra-cranici. Questo articolo si propone di riassumere i principi, la tecnica e le principali applicazioni cliniche degli studi di perfusione cerebrale basati sulla metodica TC.

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Authors and Affiliations

  1. Dipartimento di Bio-immagini e Scienze Radiologiche, Sezione di Radiodiagnostica, Università Cattolica del Sacro Cuore, Policlinico “A. Gemelli”, L.go Gemelli 8., I-00168, Rome, Italy

    A. Cianfoni, C. Colosimo, M. Basile & L. Bonomo

  2. Deptartment of Radiology, Neuroradiology Section, UCSF — University of California San Francisco, San Francisco, CA, USA

    M. Wintermark

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  1. A. Cianfoni
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  2. C. Colosimo
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  3. M. Basile
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  4. M. Wintermark
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  5. L. Bonomo
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Correspondence to A. Cianfoni.

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Cianfoni, A., Colosimo, C., Basile, M. et al. Brain perfusion CT: Principles, technique and clinical applications. Radiol med 112, 1225–1243 (2007). https://doi.org/10.1007/s11547-007-0219-4

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