Whole-brain dynamic CT angiography and perfusion imaging

Orrison, William W.; Snyder, Kenneth V.; Hopkins, L. Nelson; Roach, Cayce J.; Ringdahl, Erik N.; Nazir, Rashid; Hanson, Eric H.

doi:10.1016/j.crad.2010.12.014

Cited by 49 publications

(24 citation statements)

References 28 publications

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“…With the introduction of 320-detector row CT perfusion scanners, perfusion maps of the whole brain (including posterior fossa structures) can now be rapidly obtained in minutes. 40 Two illustrative cases of CT perfusion findings in patients with ischemic stroke who received emergent endovascular interventions are shown in Figs. 3 and 4.…”

Section: Noncontrast Ct Scanningmentioning

confidence: 99%

Intracerebral hemorrhage secondary to intravenous and endovascular intraarterial revascularization therapies in acute ischemic stroke: an update on risk factors, predictors, and management

Mokin¹,

Kan

Kass‐Hout³

et al. 2012

FOC

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Intracerebral hemorrhage (ICH) secondary to intravenous and intraarterial revascularization strategies for emergent treatment of acute ischemic stroke is associated with high mortality. ICH from systemic thrombolysis typically occurs within the first 24–36 hours of treatment initiation and is characterized by rapid hematoma development and growth. Pathophysiological mechanisms of revascularization therapy-induced ICH are complex and involve a combination of several distinct processes, including the direct effect of thrombolytic agents, disruption of the blood-brain barrier secondary to ischemia, and direct vessel damage from wire and microcatheter manipulations during endovascular procedures. Several definitions of ICH secondary to thrombolysis currently exist, depending on clinical or radiological characteristics used. Multiple studies have investigated clinical and laboratory risk factors associated with higher rates of ICH in this setting. Early ischemic changes seen on noncontrast CT scanning are strongly associated with higher rates of hemorrhage. Modern imaging techniques, particularly CT perfusion, provide rapid assessment of hemodynamic parameters of the brain. Specific patterns of CT perfusion maps can help identify patients who are likely to benefit from revascularization or to develop hemorrhagic complications. There are no established guidelines that describe management of revascularization therapy–induced ICH, and great variability in treatment protocols currently exist. General principles that apply to the management of spontaneous ICH might not be as effective for revascularization therapy–induced ICH. In this article, the authors review current knowledge of risk factors and radiological predictors of ICH secondary to stroke revascularization techniques and analyze medical and surgical management strategies for ICH in this setting.

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Section: Noncontrast Ct Scanningmentioning

confidence: 99%

Intracerebral hemorrhage secondary to intravenous and endovascular intraarterial revascularization therapies in acute ischemic stroke: an update on risk factors, predictors, and management

Mokin¹,

Kan

Kass‐Hout³

et al. 2012

FOC

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show abstract

“…Time resolved whole-brain perfusion CT is a well-established quantitative technique in assessing various perfusion parameters, such as cerebral blood flow, cerebral blood volume, mean time transit, and time to peak, with an acceptable mean X-ray exposure of typically 5-7 mSv (Orrison et al 2011). Translation to the myocardium, however, is challenging due to its inherent rapid motion, and represents a novel approach that is currently under investigation.…”

Section: Technical Aspects Acquisition Protocol and Radiation Dosementioning

confidence: 99%

CT Evaluation of the Myocardial Blood Supply: Single-Source, Single-Energy CT

Nikolaou¹

2012

CT Imaging of Myocardial Perfusion and Viability

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“…The utility of CTA source images may become questionable with the availability of new generation scanners. 25,34 Until then, CTA source images have a role in delineating irreversibly infarcted brain tissue in patients presenting with acute ischemic stroke. Minor stroke and TIA is the largest group of cerebrovascular disease patients.…”

Section: Computed Tomography Angiography Source Imagesmentioning

confidence: 99%

Computed Tomography Angiography in the Assessment of Patients With Stroke/TIA

Menon

Demchuk

2011

The Neurohospitalist

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Rapid advance in medical technology has resulted in the availability of numerous tests and treatment strategies in the management of acute stroke. The increasingly evidence-based context of clinical medicine necessitates that clinicians use only appropriate tools to facilitate the diagnostic process and patient management. In this review, we seek to explore the use of computed tomography angiography (CTA) in the diagnosis and management of patients presenting with acute stroke (ischemic and hemorrhagic) or transient ischemic attack (TIA). We present evidence in favor of the use of CTA, highlight the disadvantages of this imaging modality, and present a heuristic model based on our experience at utilizing CTA for decision making in acute stroke and TIAs.

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Whole-brain dynamic CT angiography and perfusion imaging

Cited by 49 publications

References 28 publications

Intracerebral hemorrhage secondary to intravenous and endovascular intraarterial revascularization therapies in acute ischemic stroke: an update on risk factors, predictors, and management

Intracerebral hemorrhage secondary to intravenous and endovascular intraarterial revascularization therapies in acute ischemic stroke: an update on risk factors, predictors, and management

CT Evaluation of the Myocardial Blood Supply: Single-Source, Single-Energy CT

Computed Tomography Angiography in the Assessment of Patients With Stroke/TIA

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