Whole-Brain Volume CT Angiography can Effectively Detect Early Ischemic Cerebrovascular Diseases

2021 ◽  
Vol 17 ◽  
Author(s):  
Shi-Feng Xiang ◽  
Jun-Tao Li ◽  
Su-Jun Yang ◽  
Fang-Fang Ding ◽  
Wei-Wei Wang ◽  
...  
Keyword(s):  
Ct Scan ◽  
Ct Angiography ◽  
Brain Volume ◽  
Ct Perfusion ◽  
Cerebrovascular Diseases ◽  
Whole Brain ◽  
Ischemic Cerebrovascular Diseases ◽  
Vascular Stenosis ◽  
Cerebral Ischemic ◽  
Volume Ct

Objective: To investigate the role of whole-brain volume computed tomography (CT) perfusion in assessing early ischemic cerebrovascular diseases. Materials and Methods: Seventy-two patients with early ischemic cerebrovascular diseases who had undergone routine CT scan and 320-row volume CT whole-brain perfusion imaging within 8 h after admission were retrospectively enrolled in this one-center case-sectional study. The perfusion parameters of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), and dynamic CT angiogram (4D-CTA) were obtained and analyzed. Results: Among 72 patients, 29 cases with 37 cerebral ischemic lesions were found in plain CT scan, whereas 51 cases with 76 lesions were found in whole-brain CT perfusion, with 30.6% more patients being detected. The CBF value was significantly lower in the abnormal than normal corresponding perfusion area in the healthy hemisphere (P<0.05), while the MTT and TTP values were significantly higher in the abnormal than the normal corresponding area (P<0.05). 4D-CTA image suggested that 59 cases had different degrees of stenosis or occlusion, including 11 mild, 18 moderate, 21 severe, and 9 occlusive cases. Four-D-CTA imaging could detect significantly (P<0.05) more patients with abnormal perfusion in severe cerebral vascular stenosis or occlusion than those with no, mild or moderate stenosis (93.33% vs. 16.67%) (P<0.05). The stenosis of intracranial and carotid arteries was positively correlated with MTT and TTP values (P<0.05). Conclusion: Whole-brain volume CT angiography can comprehensively display early cerebral ischemic lesions, cerebral blood perfusion status, and cerebral vascular stenosis, providing valuable information for early detection of ischemic cerebral diseases and appropriate treatment planning.

scholarly journals The Vulnerability of Vessels Involved in the Role of Embolism and Hypoperfusion in the Mechanisms of Ischemic Cerebrovascular Diseases

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Yong Peng Yu ◽  
Lan Tan
Keyword(s):  
Cerebral Infarction ◽  
Dominant Role ◽  
Cerebrovascular Diseases ◽  
Effective Care ◽  
Cerebrovascular Events ◽  
Accurate Definition ◽  
Ischemic Cerebrovascular Diseases ◽  
Vascular Stenosis

Accurate definition and better understanding of the mechanisms of stroke are crucial as this will guide the effective care and therapy. In this paper, we review the previous basic and clinical researches on the causes or mechanisms of ischemic cerebrovascular diseases (ICVD) and interpret the correlation between embolism and hypoperfusion based on vascular stenosis and arterial intimal lesions. It was suggested that if there is no embolus (dynamic or in situ emboli), there might be no cerebral infarction. Three kinds of different clinical outcomes of TIA were theoretically interpreted based on its mechanisms. We suppose that there is a correlation between embolism and hypoperfusion, and which mechanisms (hypoperfusion or hypoperfusion induced microemboli) playing the dominant role in each type of ICVD depends on the unique background of arterial intimal lesions (the vulnerability of vessels). That is to say, the vulnerability of vessels is involved in the role of embolism and hypoperfusion in the mechanisms of ischemic cerebrovascular diseases. This inference might enrich and provide better understandings for the underlying etiologies of ischemic cerebrovascular events.

The value of whole-brain CT perfusion imaging and CT angiography using a 320-slice CT scanner in the diagnosis of MCI and AD patients

2017 ◽  
Vol 27 (11) ◽  
pp. 4756-4766 ◽  
Author(s):  
Bo Zhang ◽  
Guo-jun Gu ◽  
Hong Jiang ◽  
Yi Guo ◽  
Xing Shen ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Perfusion Imaging ◽  
Ct Perfusion ◽  
Ct Scanner ◽  
Whole Brain ◽  
Brain Ct ◽  
Ct Perfusion Imaging

Goliath and the ant: whole-brain CT perfusion against 16-slice CT angiography in stroke imaging

2019 ◽  
Vol 46 (6) ◽  
pp. 398-400
Author(s):  
Nicola Morelli ◽  
Eugenia Rota ◽  
Davide Colombi ◽  
Giuseppe Marchesi ◽  
Elena Villaggi ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Ct Perfusion ◽  
Whole Brain ◽  
Brain Ct ◽  
Stroke Imaging

Whole brain CT perfusion combined with CT angiography in patients with subarachnoid hemorrhage and cerebral vasospasm

2013 ◽  
Vol 115 (12) ◽  
pp. 2496-2501 ◽  
Author(s):  
He Zhang ◽  
Bo Zhang ◽  
Shu Li ◽  
Chuansheng Liang ◽  
Ke Xu ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Ct Angiography ◽  
Cerebral Vasospasm ◽  
Ct Perfusion ◽  
Whole Brain ◽  
Brain Ct

scholarly journals Evaluation of Revascularization in Different Suzuki Stages of Ischemic Moyamoya Disease by Whole-Brain CT Perfusion

2021 ◽  
Vol 12 ◽  
Author(s):  
Qingdong Han ◽  
Feirong Yao ◽  
Zhengyu Zhang ◽  
Yabo Huang
Keyword(s):  
Moyamoya Disease ◽  
Late Stage ◽  
Bypass Surgery ◽  
Brain Volume ◽  
Ct Perfusion ◽  
Early Stage ◽  
Hemodynamic Parameters ◽  
Whole Brain ◽  
Brain Ct ◽  
Before And After

Objective: This study compared the clinical features and hemodynamic characteristics of patients in different Suzuki stages of ischemic moyamoya disease (iMMD) before and after treatment with extracranial-intracranial (EC-IC) bypass surgery combined with encephalo-duro-myo-synangiosis and whole-brain computed tomography perfusion (WB-CTP).Methods: A total of 126 patients in different Suzuki stages (II, III, IV, and V) of iMMD who underwent bypass surgery from April 2013 to August 2020 were included in this retrospective study. MIStar automatic analysis of Whole brain CT perfusion imaging software (WB-CTP, Apollo Medical Imaging Technology, Melbourne, Australia) was used. The patients also underwent WB-CTP 1 day before and 1 week and 3 months after the surgery. The relationships between hemodynamic parameters in WB-CTP including delay time (DT) &gt; 3 s, relative cerebral blood flow (rCBF) &lt; 30%, mismatch and mismatch ratio, and clinical outcomes were evaluated for different Suzuki stages, with comparisons between early (II and III) and late (IV and V) stages.Results: Combined bypass surgery was performed in 161 hemispheres of 126 patients with iMMD. Brain volume with DT &gt; 3 s was decreased 1 week (51.5 ± 11.8 ml, P &lt; 0.05) and 3 months (41.5 ± 10.7 ml, P &lt; 0.05) after bypass compared to 1 day before bypass (104.7 ± 15.1 ml) in early-stage patients. In late-stage patients, the volume was increased 1 week after bypass compared to the preoperative value (154.3 ± 14.7 vs. 118.3 ± 19.1 ml, P &lt; 0.05). Preoperative brain volume with rCBF &lt; 30% was lower (9.8 ± 3.9 vs. 33.5 ± 11.0 ml) whereas preoperative mismatch ratio was higher (11.2 ± 2.8 vs. 3.6 ± 1.6) in early-stage as compared to late-stage patients (both P &lt; 0.05). A higher modified Rankin scale score (0–1) was achieved by early-stage patients than by those in the late stage (93.8 vs. 80.4%, P &lt; 0.05) at the 3-month follow-up.Conclusions: WB-CTP is useful for assessing the effectiveness of combined bypass/revascularization in different Suzuki stages of iMMD. Patients in the early stage of disease with higher preoperative brain volume with DT &gt; 3 s and mismatch ratio show greater improvements in hemodynamic parameters and fewer postoperative complications associated with hemodynamic disturbance following bypass than patients in the late stage. Preoperative mismatch ratio can serve as a marker for assessing the status of collateral circulation in different Suzuki stages of iMMD.

scholarly journals Steroid-Responsive Large Vessel Vasculitis: Application of Whole-Brain 320-Detector Row Dynamic Volume CT Angiography and Perfusion

2009 ◽  
Vol 30 (7) ◽  
pp. 1409-1411 ◽  
Author(s):  
N. Yahyavi-Firouz-Abadi ◽  
B.L. Wynn ◽  
F.J. Rybicki ◽  
M.L. Steigner ◽  
A.Z. Hussain ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Whole Brain ◽  
Volume Ct ◽  
Dynamic Volume Ct

scholarly journals CT Perfusion Imaging Improves Infarct Conspicuity in Hyperacute Stroke

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 325-325
Author(s):  
Peter Bove ◽  
Michael H Lev ◽  
Dmetri Berdichevsky ◽  
Gordon J Harris ◽  
Nathaniel M Alpert ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Blood Volume ◽  
Gray Matter ◽  
Cerebral Blood Volume ◽  
Ct Perfusion ◽  
Blood Pool ◽  
Hyperacute Stroke ◽  
Tissue Edema ◽  
The Mean ◽  
Volume Ct

51 Purpose: To compare infarct conspicuity and image quality of noncontrast CT (NCCT), CT perfusion (CTP), and CT subtraction cerebral blood volume (CT-CBV) images of patients with hyperacute stroke. Background: NCCT is typically the first imaging test obtained in the evaluation of acute stroke. Whole brain CTP imaging is performed, simultaneously with CT angiography, during the steady state administration of IV contrast. Subtraction of coregistered NCCT images from the CTP images yields maps of perfused blood volume (CT-CBV). Ischemic areas on each of the NCCT, CTP, and CT-CBV images appear as hypodense, low attenuation regions. Materials and Methods: We reviewed the images of 20 consecutive patients with MCA stem occlusion who underwent intra-arterial thrombolysis within 6 hours of stroke onset. All had NCCT and CT angiography with CTP imaging prior to thrombolysis. Subtraction CT-CBV maps were created and analyzed using proprietary software (IMIPS, Inc). For each of the NCCT, CTP, and CT-CBV images, infarct conspicuity was defined by dividing the mean attenuation difference between normal and maximally hypodense gray matter by the mean normal gray matter attenuation. Contrast-to-noise ratio (CNR) was defined by dividing the same numerator by the standard deviation of the normal gray matter attenuation values. Statistical analysis was by ANOVA and students t-test. Results: Overall infarct conspicuity was 0.11 for the NCCT, 0.22 for the CTP, and 0.98 for the CT-CBV images (p<0.003 for all maps). Mean CNR was 0.95 for the NCCT, 1.94 for the CTP, and 1.12 for the CT-CBV images (p<0.01, for the CTP maps only). Conclusions: CT perfusion and CT-CBV subtraction imaging improve infarct conspicuity over that of NCCT in patients with hyperacute stroke. True reduction in blood pool (as reflected by CT-CBV), rather than increase in tissue edema (as reflected by NCCT), may explain much of the improved infarct delineation in CTP imaging. Because CNR is greater for CTP than for subtraction images, concurrent review of NCCT, CTP, and CT-CBV images may be indicated for optimal CT assessment of hyperacute MCA stroke.

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