1、3D Blood Volume Imaging Acute Ischemic StrokeKuncheng Li M.D.,Ph.D.Medical Imaging CenterDepartment of RadiologyXuanwu Hospital Capital Medical UniversityBeijing 100053 China Non-enhanced CT (NECT) : could exclude hemorrhage and indicate early signs of ischemic strokePerfusion CT (PCT) : shows hemod
2、ynamic statusCT angiography (CTA) : shows vascular occlusion locationComprehensive Imaging in 15 MinutesPerfusion CT Images from PCT: MIP CBF CBV TTPBUT: limited coverageWhole brain perfusionis ideal!Calculating 3D-PBV ImagesCTAlowpassfilteringNECTRegistrationuses information3D PBVSkullBones CSFBone
3、sVesselsPre-Studiesof 3D-PBVMaterials and Methods Twenty-five patients (7 women, 18 men; mean age 59 years; range 42-77 years) suffered from acute ischemic stroke of the anterior circulation were studied within 6h after onset of symptoms NECT, CTA and CTP were performed within an average time of 2.8
4、 hours (range 1-6 hours) after onset of symptoms Intravenous or intra-arterial thrombolytic therapy was performed in 11 of 25 patients Follow-up CT and MRI examinations were done at 2 to 7 days for the depiction of definite infarction NECT: spiral mode covering the base to vertexreconstruct with 5/1
5、mm slice thickness CTP: dynamic scan 3 adjacent slices (28.8 mmthickness) covering the basal ganglia 40 ml non-ionic contrast, 8 ml/sec CTA: spiral mode covering C5 to vertex 60 ml non-ionic contrast, 4 ml/secCT Scan ProtocolResults NECT: signs of ischemia were demonstrated in 13 of 25 acute stroke
6、patients CTP: CBF, CBV, and TTP demonstrated perfusion deficits in 21 patients CBF, CBV, and TTP demonstrated suspectedperfusion deficits in 2 patients Only TTP demonstrated perfusion deficits in 2 of 25 patients 3D-PBV: demonstrated perfusion deficits in all of the 25 acute stroke patients 3D-PBV h
7、as a higher detection rate for infarct lesion than NECT and CTP, and can depict the whole infarction lesionResults CTP: lesion volume significantly correlated with the follow-up CT (R=0.776/P0.001 for CBF; R=0.723/ P0.001 for CBV; R=0.629/P=0.001 for TTP) PBV: lesion volume significantly correlated with the follow-up CT (R=0.837, P0.001)020406080100120PBV CBF CBV TTP CTVolume cm3
