Neuroradiology Department, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
AJNR Am J Neuroradiol. 2010 Jan;31(1):34-9. doi: 10.3174/ajnr.A1740. Epub 2009 Oct 29.
CT perfusion (CTP) mapping has been reported to be useful in the differentiation of the infarct core and ischemic penumbra. However, the value of the CTP source imaging (CTP-SI) during the arterial and venous phases has not been fully investigated. The purpose of this study was to develop a CTP-SI methodology for acute ischemic stroke and compare its efficacy with cerebral blood flow (CBF) and cerebral blood volume (CBV) in predicting infarct core and penumbra.
CT examinations, including non-contrast-enhanced CT, CTP, and CT angiography (CTA), were performed in 42 patients with symptoms of stroke for <9 hours. The Alberta Stroke Program Early CT Score (ASPECTS) was analyzed on the arterial phase CTP-SI and venous phase CTP-SI and then compared with the ASPECTS on CBF and CBV for efficacy assessment.
The ASPECTS on the arterial phase CTP-SI was closely correlated with the ASPECTS on CBF, the Pearson correlation coefficient was 0.88 (P < .001), and the concordance correlation coefficient was 0.7603 (95% confidence interval [CI], 0.6331-0.8476). The ASPECTS on the venous phase CTP-SI revealed a significant correlation with the ASPECTS on CBV, the Pearson correlation coefficient was 0.92 (P < .001), and the concordance correlation coefficient was 0.8880 (95% CI, 0.8148-0.9334). Significant differences were shown between the arterial phase CTP-SI/ venous phase CTP-SI (P < .001) and CBF/CBV (P < .001).
This study provides preliminary evidence that the arterial phase and venous phase CTP-SI mismatch model could possibly be applied to ischemic regions in the acute stage of stroke to determine penumbra and infarct core.
CT 灌注（CTP）成像已被报道可用于鉴别梗死核心和缺血半暗带。然而，CTP 源成像（CTP-SI）在动脉期和静脉期的价值尚未得到充分研究。本研究旨在开发一种急性缺血性脑卒中 CTP-SI 方法，并比较其在预测梗死核心和半暗带方面与脑血流量（CBF）和脑血容量（CBV）的效果。
对 42 例发病<9 小时的脑卒中症状患者进行 CT 检查，包括非增强 CT、CTP 和 CT 血管造影（CTA）。在动脉期 CTP-SI 和静脉期 CTP-SI 上分析 Alberta 卒中项目早期 CT 评分（ASPECTS），然后与 CBF 和 CBV 的 ASPECTS 进行比较，以评估其效果。
动脉期 CTP-SI 的 ASPECTS 与 CBF 的 ASPECTS 密切相关，Pearson 相关系数为 0.88（P<0.001），一致性相关系数为 0.7603（95%置信区间[CI]，0.6331-0.8476）。静脉期 CTP-SI 的 ASPECTS 与 CBV 的 ASPECTS 显著相关，Pearson 相关系数为 0.92（P<0.001），一致性相关系数为 0.8880（95%置信区间[CI]，0.8148-0.9334）。动脉期 CTP-SI/静脉期 CTP-SI（P<0.001）和 CBF/CBV（P<0.001）之间存在显著差异。
本研究初步证实，动脉期和静脉期 CTP-SI 失配模型可用于确定脑卒中急性期缺血区域的半暗带和梗死核心。
