Skip to main content
Top
Published in: Translational Stroke Research 2/2012

01-06-2012 | Review Article

Improving Acute Stroke Management with Computed Tomography Perfusion: A Review of Imaging Basics and Applications

Authors: C. D. d’Esterre, Enrico Fainardi, R. I. Aviv, T. Y. Lee

Published in: Translational Stroke Research | Issue 2/2012

Login to get access

Abstract

The inclusion of dynamic contrast-enhanced computed tomography (CT) or CT perfusion (CTP) scan into the imaging workup for acute stroke patients is widespread. Along with vessel occlusion status from CT angiography, CTP provides pathophysiological information a non-contrast CT cannot provide during the hyperacute stages of cerebral ischemia. Measurement of parenchymal perfusion at the capillary level can be used to characterize tissue viability, a target for thrombolysis. Further, CTP is useful for the detection of blood brain barrier disturbances with the permeability surface area product parameter (PS). Although new to stroke imaging, PS has diagnostic and prognostic implications for primary hemorrhage and secondary hemorrhagic transformation of ischemic stroke. The purpose of this article is to provide an overview of the CTP imaging concepts and their uses for imaging in stroke.
Literature
1.
go back to reference Kleindorfer DO, Khoury J, Moomaw CJ, et al. Stroke incidence is decreasing in Whites but not in Blacks: a population-based estimate of temporal trends in stroke incidence from the Greater Cincinnati/Northern Kentucky Stroke Study. Stroke. 2010;41(7):1326–31.PubMedCrossRef Kleindorfer DO, Khoury J, Moomaw CJ, et al. Stroke incidence is decreasing in Whites but not in Blacks: a population-based estimate of temporal trends in stroke incidence from the Greater Cincinnati/Northern Kentucky Stroke Study. Stroke. 2010;41(7):1326–31.PubMedCrossRef
2.
go back to reference Carandang R, Seshadri S, Beiser A, et al. Trends in incidence, lifetime risk, severity, and 30-day mortality of stroke over the past 50 years. JAMA. 2006;296(24):2939–46.PubMedCrossRef Carandang R, Seshadri S, Beiser A, et al. Trends in incidence, lifetime risk, severity, and 30-day mortality of stroke over the past 50 years. JAMA. 2006;296(24):2939–46.PubMedCrossRef
3.
go back to reference Xian Y, Holloway RG, Noyes K, Shah MN, Friedman B. Racial differences in mortality among patients with acute ischemic stroke: an observational study. Ann Intern Med. 2011;154(3):152–9. Feb 1.PubMed Xian Y, Holloway RG, Noyes K, Shah MN, Friedman B. Racial differences in mortality among patients with acute ischemic stroke: an observational study. Ann Intern Med. 2011;154(3):152–9. Feb 1.PubMed
4.
go back to reference Mohan KM, Crichton SL, Grieve AP, Rudd AG, Wolfe CD, Heuschmann PU. Frequency and predictors for the risk of stroke recurrence up to 10 years after stroke: the South London Stroke Register. J Neurol Neurosurg Psychiatry. 2009;80(9):1012–8.PubMedCrossRef Mohan KM, Crichton SL, Grieve AP, Rudd AG, Wolfe CD, Heuschmann PU. Frequency and predictors for the risk of stroke recurrence up to 10 years after stroke: the South London Stroke Register. J Neurol Neurosurg Psychiatry. 2009;80(9):1012–8.PubMedCrossRef
5.
go back to reference Minino A. Deaths: final data for 2008. Natl Vital Stat Rep. 2011;59(10):1–2. Minino A. Deaths: final data for 2008. Natl Vital Stat Rep. 2011;59(10):1–2.
6.
go back to reference Wintermark M, Albers GW, Alexandrov AV, et al. Acute stroke imaging research roadmap. AJNR Am J Neuroradiol. 2008;29(5):e23–30.PubMedCrossRef Wintermark M, Albers GW, Alexandrov AV, et al. Acute stroke imaging research roadmap. AJNR Am J Neuroradiol. 2008;29(5):e23–30.PubMedCrossRef
7.
go back to reference Aviv RI, d'Esterre CD, Murphy BD, et al. Hemorrhagic transformation of ischemic stroke: prediction with CT perfusion. Radiology. 2009;250(3):867–77.PubMedCrossRef Aviv RI, d'Esterre CD, Murphy BD, et al. Hemorrhagic transformation of ischemic stroke: prediction with CT perfusion. Radiology. 2009;250(3):867–77.PubMedCrossRef
8.
go back to reference Lee TY. Functional CT: physiological models. Trends in Biotechnology. 2002;20(8):suppl. Lee TY. Functional CT: physiological models. Trends in Biotechnology. 2002;20(8):suppl.
9.
go back to reference Konstas AA, Goldmakher GV, Lee TY, Lev MH. Theoretic basis and technical implementations of CT perfusion in acute ischemic stroke, part 2: technical implementations. AJNR Am J Neuroradiol. 2009;30(5):885–92.PubMedCrossRef Konstas AA, Goldmakher GV, Lee TY, Lev MH. Theoretic basis and technical implementations of CT perfusion in acute ischemic stroke, part 2: technical implementations. AJNR Am J Neuroradiol. 2009;30(5):885–92.PubMedCrossRef
10.
go back to reference Nabavi DG, Cenic A, Henderson S, Gelb AW, Lee TY. Perfusion mapping using computed tomography allows accurate prediction of cerebral infarction in experimental brain ischemia. Stroke. 2001;32(1):175–83.PubMedCrossRef Nabavi DG, Cenic A, Henderson S, Gelb AW, Lee TY. Perfusion mapping using computed tomography allows accurate prediction of cerebral infarction in experimental brain ischemia. Stroke. 2001;32(1):175–83.PubMedCrossRef
11.
go back to reference Gamel J, Rousseau WF, Katholi CR, Mesel E. Pitfalls in digital computation of the impulse response of vascular beds from indicator–dilution curves. Circ Res. 1973;32(4):516–23.PubMed Gamel J, Rousseau WF, Katholi CR, Mesel E. Pitfalls in digital computation of the impulse response of vascular beds from indicator–dilution curves. Circ Res. 1973;32(4):516–23.PubMed
12.
go back to reference Cenic A, Nabavi DG, Craen RA, Gelb AW, Lee TY. Dynamic CT measurement of cerebral blood flow: a validation study. AJNR Am J Neuroradiol. 1999;20(1):63–73.PubMed Cenic A, Nabavi DG, Craen RA, Gelb AW, Lee TY. Dynamic CT measurement of cerebral blood flow: a validation study. AJNR Am J Neuroradiol. 1999;20(1):63–73.PubMed
13.
go back to reference Lee TY, Purdie TG, Stewart E. CT imaging of angiogenesis. Q J Nucl Med. 2003;47(3):171–87.PubMed Lee TY, Purdie TG, Stewart E. CT imaging of angiogenesis. Q J Nucl Med. 2003;47(3):171–87.PubMed
14.
go back to reference Groothuis DR, Vriesendorp FJ, Kupfer B, et al. Quantitative measurements of capillary transport in human brain tumors by computed tomography. Ann Neurol. 1991;30(4):581–8.PubMedCrossRef Groothuis DR, Vriesendorp FJ, Kupfer B, et al. Quantitative measurements of capillary transport in human brain tumors by computed tomography. Ann Neurol. 1991;30(4):581–8.PubMedCrossRef
15.
go back to reference Yeung WT, Lee TY, Del Maestro RF, Kozak R, Brown T. In vivo CT measurement of blood–brain transfer constant of iopamidol in human brain tumors. J Neurooncol. 1992;14(2):177–87.PubMed Yeung WT, Lee TY, Del Maestro RF, Kozak R, Brown T. In vivo CT measurement of blood–brain transfer constant of iopamidol in human brain tumors. J Neurooncol. 1992;14(2):177–87.PubMed
16.
go back to reference Patlak CS, Blasberg RG. Graphical evaluation of blood-to-brain transfer constants from multiple-time uptake data. Generalizations. J Cereb Blood Flow Metab. 1985;5(4):584–90.PubMedCrossRef Patlak CS, Blasberg RG. Graphical evaluation of blood-to-brain transfer constants from multiple-time uptake data. Generalizations. J Cereb Blood Flow Metab. 1985;5(4):584–90.PubMedCrossRef
17.
go back to reference St Lawrence KS, Lee TY. An adiabatic approximation to the tissue homogeneity model for water exchange in the brain: I. Theoretical derivation. J Cereb Blood Flow Metab. 1998;18(12):1365–77.PubMedCrossRef St Lawrence KS, Lee TY. An adiabatic approximation to the tissue homogeneity model for water exchange in the brain: I. Theoretical derivation. J Cereb Blood Flow Metab. 1998;18(12):1365–77.PubMedCrossRef
18.
go back to reference St Lawrence KS, Lee TY. An adiabatic approximation to the tissue homogeneity model for water exchange in the brain: II. Experimental validation. J Cereb Blood Flow Metab. 1998;18(12):1378–85.PubMedCrossRef St Lawrence KS, Lee TY. An adiabatic approximation to the tissue homogeneity model for water exchange in the brain: II. Experimental validation. J Cereb Blood Flow Metab. 1998;18(12):1378–85.PubMedCrossRef
19.
go back to reference Nabavi DG, Cenic A, Dool J, et al. Quantitative assessment of cerebral hemodynamics using CT: stability, accuracy, and precision studies in dogs. J Comput Assist Tomogr. 1999;23(4):506–15. Jul-Aug.PubMedCrossRef Nabavi DG, Cenic A, Dool J, et al. Quantitative assessment of cerebral hemodynamics using CT: stability, accuracy, and precision studies in dogs. J Comput Assist Tomogr. 1999;23(4):506–15. Jul-Aug.PubMedCrossRef
20.
go back to reference Furukawa M, Kashiwagi S, Matsunaga N, Suzuki M, Kishimoto K, Shirao S. Evaluation of cerebral perfusion parameters measured by perfusion CT in chronic cerebral ischemia: comparison with xenon CT. J Comput Assist Tomogr. 2002;26(2):272–8. Mar-Apr.PubMedCrossRef Furukawa M, Kashiwagi S, Matsunaga N, Suzuki M, Kishimoto K, Shirao S. Evaluation of cerebral perfusion parameters measured by perfusion CT in chronic cerebral ischemia: comparison with xenon CT. J Comput Assist Tomogr. 2002;26(2):272–8. Mar-Apr.PubMedCrossRef
21.
go back to reference Eastwood JD, Lev MH, Wintermark M, et al. Correlation of early dynamic CT perfusion imaging with whole-brain MR diffusion and perfusion imaging in acute hemispheric stroke. AJNR Am J Neuroradiol. 2003;24(9):1869–75.PubMed Eastwood JD, Lev MH, Wintermark M, et al. Correlation of early dynamic CT perfusion imaging with whole-brain MR diffusion and perfusion imaging in acute hemispheric stroke. AJNR Am J Neuroradiol. 2003;24(9):1869–75.PubMed
22.
go back to reference Gillard JH, Antoun NM, Burnet NG, Pickard JD. Reproducibility of quantitative CT perfusion imaging. Br J Radiol. 2001;74(882):552–5.PubMed Gillard JH, Antoun NM, Burnet NG, Pickard JD. Reproducibility of quantitative CT perfusion imaging. Br J Radiol. 2001;74(882):552–5.PubMed
23.
go back to reference Kudo K, Terae S, Katoh C, et al. Quantitative cerebral blood flow measurement with dynamic perfusion CT using the vascular-pixel elimination method: comparison with H2(15)O positron emission tomography. AJNR Am J Neuroradiol. 2003;24(3):419–26.PubMed Kudo K, Terae S, Katoh C, et al. Quantitative cerebral blood flow measurement with dynamic perfusion CT using the vascular-pixel elimination method: comparison with H2(15)O positron emission tomography. AJNR Am J Neuroradiol. 2003;24(3):419–26.PubMed
24.
go back to reference Wintermark M, Thiran JP, Maeder P, Schnyder P, Meuli R. Simultaneous measurement of regional cerebral blood flow by perfusion CT and stable xenon CT: a validation study. AJNR Am J Neuroradiol. 2001;22(5):905–14.PubMed Wintermark M, Thiran JP, Maeder P, Schnyder P, Meuli R. Simultaneous measurement of regional cerebral blood flow by perfusion CT and stable xenon CT: a validation study. AJNR Am J Neuroradiol. 2001;22(5):905–14.PubMed
25.
go back to reference Miles KA, Griffiths MR. Perfusion CT: a worthwhile enhancement? Br J Radiol. 2003;76(904):220–31.PubMedCrossRef Miles KA, Griffiths MR. Perfusion CT: a worthwhile enhancement? Br J Radiol. 2003;76(904):220–31.PubMedCrossRef
26.
go back to reference Abels B, Klotz E, Tomandl BF, Kloska SP, Lell MM. Perfusion CT in acute ischemic stroke: a qualitative and quantitative comparison of deconvolution and maximum slope approach. AJNR Am J Neuroradiol. Oct;31(9):1690-1698. Abels B, Klotz E, Tomandl BF, Kloska SP, Lell MM. Perfusion CT in acute ischemic stroke: a qualitative and quantitative comparison of deconvolution and maximum slope approach. AJNR Am J Neuroradiol. Oct;31(9):1690-1698.
27.
go back to reference Wintermark M, Smith WS, Ko NU, Quist M, Schnyder P, Dillon WP. Dynamic perfusion CT: optimizing the temporal resolution and contrast volume for calculation of perfusion CT parameters in stroke patients. AJNR Am J Neuroradiol. 2004;25(5):720–9.PubMed Wintermark M, Smith WS, Ko NU, Quist M, Schnyder P, Dillon WP. Dynamic perfusion CT: optimizing the temporal resolution and contrast volume for calculation of perfusion CT parameters in stroke patients. AJNR Am J Neuroradiol. 2004;25(5):720–9.PubMed
28.
go back to reference Wintermark M, Reichhart M, Thiran JP, et al. Prognostic accuracy of cerebral blood flow measurement by perfusion computed tomography, at the time of emergency room admission, in acute stroke patients. Ann Neurol. 2002;51(4):417–32.PubMedCrossRef Wintermark M, Reichhart M, Thiran JP, et al. Prognostic accuracy of cerebral blood flow measurement by perfusion computed tomography, at the time of emergency room admission, in acute stroke patients. Ann Neurol. 2002;51(4):417–32.PubMedCrossRef
29.
go back to reference Lencioni R, Fattori R, Morana G, Stacul F. Contrast-induced nephropathy in patients undergoing computed tomography (CONNECT)—a clinical problem in daily practice? A multicenter observational study. Acta Radiol. Sep;51(7):741-750. Lencioni R, Fattori R, Morana G, Stacul F. Contrast-induced nephropathy in patients undergoing computed tomography (CONNECT)—a clinical problem in daily practice? A multicenter observational study. Acta Radiol. Sep;51(7):741-750.
30.
go back to reference d'Esterre CD, Chia TL, Jairath A, Lee TY, Symons SP, Aviv RI. Early rate of contrast extravasation in patients with intracerebral hemorrhage. AJNR Am J Neuroradiol. Nov-Dec;32(10):1879-1884. d'Esterre CD, Chia TL, Jairath A, Lee TY, Symons SP, Aviv RI. Early rate of contrast extravasation in patients with intracerebral hemorrhage. AJNR Am J Neuroradiol. Nov-Dec;32(10):1879-1884.
31.
go back to reference Hom J, Dankbaar JW, Soares BP, et al. Blood–brain barrier permeability assessed by perfusion CT predicts symptomatic hemorrhagic transformation and malignant edema in acute ischemic stroke. AJNR Am J Neuroradiol. Jan;32(1):41-48. Hom J, Dankbaar JW, Soares BP, et al. Blood–brain barrier permeability assessed by perfusion CT predicts symptomatic hemorrhagic transformation and malignant edema in acute ischemic stroke. AJNR Am J Neuroradiol. Jan;32(1):41-48.
32.
go back to reference Wintermark M, Albers GW, Alexandrov AV, et al. Acute stroke imaging research roadmap. Stroke. 2008;39(5):1621–8.PubMedCrossRef Wintermark M, Albers GW, Alexandrov AV, et al. Acute stroke imaging research roadmap. Stroke. 2008;39(5):1621–8.PubMedCrossRef
33.
go back to reference Frey GD, Rumboldt Z. Radiation effects from perfusion CT. Radiology. 2005;234(2):638. author reply 638.PubMedCrossRef Frey GD, Rumboldt Z. Radiation effects from perfusion CT. Radiology. 2005;234(2):638. author reply 638.PubMedCrossRef
34.
go back to reference Rapalino O, Kamalian S, Payabvash S, et al. Cranial CT with adaptive statistical iterative reconstruction: improved image quality with concomitant radiation dose reduction. AJNR Am J Neuroradiol. Jan 19 (epub ahead of print) Rapalino O, Kamalian S, Payabvash S, et al. Cranial CT with adaptive statistical iterative reconstruction: improved image quality with concomitant radiation dose reduction. AJNR Am J Neuroradiol. Jan 19 (epub ahead of print)
35.
go back to reference Wu O, Ostergaard L, Koroshetz WJ, et al. Effects of tracer arrival time on flow estimates in MR perfusion-weighted imaging. Magn Reson Med. 2003;50(4):856–64.PubMedCrossRef Wu O, Ostergaard L, Koroshetz WJ, et al. Effects of tracer arrival time on flow estimates in MR perfusion-weighted imaging. Magn Reson Med. 2003;50(4):856–64.PubMedCrossRef
36.
go back to reference Wu O, Ostergaard L, Weisskoff RM, Benner T, Rosen BR, Sorensen AG. Tracer arrival timing-insensitive technique for estimating flow in MR perfusion-weighted imaging using singular value decomposition with a block-circulant deconvolution matrix. Magn Reson Med. 2003;50(1):164–74.PubMedCrossRef Wu O, Ostergaard L, Weisskoff RM, Benner T, Rosen BR, Sorensen AG. Tracer arrival timing-insensitive technique for estimating flow in MR perfusion-weighted imaging using singular value decomposition with a block-circulant deconvolution matrix. Magn Reson Med. 2003;50(1):164–74.PubMedCrossRef
37.
go back to reference Willats L, Connelly A, Calamante F. Minimising the effects of bolus dispersion in bolus-tracking MRI. NMR Biomed. 2008;21(10):1126–37.PubMedCrossRef Willats L, Connelly A, Calamante F. Minimising the effects of bolus dispersion in bolus-tracking MRI. NMR Biomed. 2008;21(10):1126–37.PubMedCrossRef
38.
go back to reference Sanelli PC, Lev MH, Eastwood JD, Gonzalez RG, Lee TY. The effect of varying user-selected input parameters on quantitative values in CT perfusion maps. Acad Radiol. 2004;11(10):1085–92.PubMedCrossRef Sanelli PC, Lev MH, Eastwood JD, Gonzalez RG, Lee TY. The effect of varying user-selected input parameters on quantitative values in CT perfusion maps. Acad Radiol. 2004;11(10):1085–92.PubMedCrossRef
39.
go back to reference Ferreira RM, Lev MH, Goldmakher GV, et al. Arterial input function placement for accurate CT perfusion map construction in acute stroke. AJR Am J Roentgenol. May;194(5):1330-1336. Ferreira RM, Lev MH, Goldmakher GV, et al. Arterial input function placement for accurate CT perfusion map construction in acute stroke. AJR Am J Roentgenol. May;194(5):1330-1336.
40.
go back to reference Wahlgren N, Ahmed N, Davalos A, et al. Thrombolysis with alteplase 3–4.5 h after acute ischaemic stroke (SITS-ISTR): an observational study. Lancet. 2008;372(9646):1303–9.PubMedCrossRef Wahlgren N, Ahmed N, Davalos A, et al. Thrombolysis with alteplase 3–4.5 h after acute ischaemic stroke (SITS-ISTR): an observational study. Lancet. 2008;372(9646):1303–9.PubMedCrossRef
41.
go back to reference Hacke W, Kaste M, Fieschi C, et al. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS). JAMA. 1995;274(13):1017–25. Oct 4.PubMedCrossRef Hacke W, Kaste M, Fieschi C, et al. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS). JAMA. 1995;274(13):1017–25. Oct 4.PubMedCrossRef
42.
go back to reference Schumacher HC, Bateman BT, Boden-Albala B, et al. Use of thrombolysis in acute ischemic stroke: analysis of the Nationwide Inpatient Sample 1999 to 2004. Ann Emerg Med. 2007;50(2):99–107.PubMedCrossRef Schumacher HC, Bateman BT, Boden-Albala B, et al. Use of thrombolysis in acute ischemic stroke: analysis of the Nationwide Inpatient Sample 1999 to 2004. Ann Emerg Med. 2007;50(2):99–107.PubMedCrossRef
43.
go back to reference Fang MC, Cutler DM, Rosen AB. Trends in thrombolytic use for ischemic stroke in the United States. J Hosp Med. 2010;5(7):406–9.PubMedCrossRef Fang MC, Cutler DM, Rosen AB. Trends in thrombolytic use for ischemic stroke in the United States. J Hosp Med. 2010;5(7):406–9.PubMedCrossRef
44.
go back to reference Hacke W, Kaste M, Bluhmki E, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008;359(13):1317–29.PubMedCrossRef Hacke W, Kaste M, Bluhmki E, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008;359(13):1317–29.PubMedCrossRef
45.
go back to reference Bluhmki E, Chamorro A, Davalos A, et al. Stroke treatment with alteplase given 3.0–4.5 h after onset of acute ischaemic stroke (ECASS III): additional outcomes and subgroup analysis of a randomised controlled trial. Lancet Neurol. 2009;8(12):1095–102.PubMedCrossRef Bluhmki E, Chamorro A, Davalos A, et al. Stroke treatment with alteplase given 3.0–4.5 h after onset of acute ischaemic stroke (ECASS III): additional outcomes and subgroup analysis of a randomised controlled trial. Lancet Neurol. 2009;8(12):1095–102.PubMedCrossRef
46.
go back to reference Shobha N, Buchan AM, Hill MD. Thrombolysis at 3–4.5 hours after acute ischemic stroke onset—evidence from the Canadian Alteplase for Stroke Effectiveness Study (CASES) Registry. Cerebrovasc Dis. 2011;31(3):223–8. Dec 21.PubMedCrossRef Shobha N, Buchan AM, Hill MD. Thrombolysis at 3–4.5 hours after acute ischemic stroke onset—evidence from the Canadian Alteplase for Stroke Effectiveness Study (CASES) Registry. Cerebrovasc Dis. 2011;31(3):223–8. Dec 21.PubMedCrossRef
47.
go back to reference Gobin YP, Starkman S, Duckwiler GR, et al. MERCI 1: a phase 1 study of mechanical embolus removal in cerebral ischemia. Stroke. 2004;35(12):2848–54.PubMedCrossRef Gobin YP, Starkman S, Duckwiler GR, et al. MERCI 1: a phase 1 study of mechanical embolus removal in cerebral ischemia. Stroke. 2004;35(12):2848–54.PubMedCrossRef
48.
go back to reference Tenser MS, Amar AP, Mack WJ. Mechanical thrombectomy for acute ischemic stroke using the MERCI retriever and penumbra aspiration systems. World Neurosurg. Dec;76(6 Suppl):S16-23. Tenser MS, Amar AP, Mack WJ. Mechanical thrombectomy for acute ischemic stroke using the MERCI retriever and penumbra aspiration systems. World Neurosurg. Dec;76(6 Suppl):S16-23.
49.
go back to reference Baker WL, Colby JA, Tongbram V, et al. Neurothrombectomy devices for the treatment of acute ischemic stroke: state of the evidence. Ann Intern Med. Feb 15;154(4):243-252. Baker WL, Colby JA, Tongbram V, et al. Neurothrombectomy devices for the treatment of acute ischemic stroke: state of the evidence. Ann Intern Med. Feb 15;154(4):243-252.
50.
go back to reference Larrue V, von Kummer RR, Muller A, Bluhmki E. Risk factors for severe hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator: a secondary analysis of the European–Australasian Acute Stroke Study (ECASS II). Stroke. 2001;32(2):438–41.PubMedCrossRef Larrue V, von Kummer RR, Muller A, Bluhmki E. Risk factors for severe hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator: a secondary analysis of the European–Australasian Acute Stroke Study (ECASS II). Stroke. 2001;32(2):438–41.PubMedCrossRef
51.
go back to reference Albers GW, Thijs VN, Wechsler L, et al. Magnetic resonance imaging profiles predict clinical response to early reperfusion: the diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study. Ann Neurol. 2006;60(5):508–17.PubMedCrossRef Albers GW, Thijs VN, Wechsler L, et al. Magnetic resonance imaging profiles predict clinical response to early reperfusion: the diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study. Ann Neurol. 2006;60(5):508–17.PubMedCrossRef
52.
go back to reference Bandera E, Botteri M, Minelli C, Sutton A, Abrams KR, Latronico N. Cerebral blood flow threshold of ischemic penumbra and infarct core in acute ischemic stroke: a systematic review. Stroke. 2006;37(5):1334–9.PubMedCrossRef Bandera E, Botteri M, Minelli C, Sutton A, Abrams KR, Latronico N. Cerebral blood flow threshold of ischemic penumbra and infarct core in acute ischemic stroke: a systematic review. Stroke. 2006;37(5):1334–9.PubMedCrossRef
53.
go back to reference Ebinger M, De Silva DA, Christensen S, et al. Imaging the penumbra—strategies to detect tissue at risk after ischemic stroke. J Clin Neurosci. 2009;16(2):178–87.PubMedCrossRef Ebinger M, De Silva DA, Christensen S, et al. Imaging the penumbra—strategies to detect tissue at risk after ischemic stroke. J Clin Neurosci. 2009;16(2):178–87.PubMedCrossRef
54.
go back to reference Hatazawa J, Shimosegawa E, Toyoshima H, et al. Cerebral blood volume in acute brain infarction: a combined study with dynamic susceptibility contrast MRI and 99mTc-HMPAO-SPECT. Stroke. 1999;30(4):800–6.PubMedCrossRef Hatazawa J, Shimosegawa E, Toyoshima H, et al. Cerebral blood volume in acute brain infarction: a combined study with dynamic susceptibility contrast MRI and 99mTc-HMPAO-SPECT. Stroke. 1999;30(4):800–6.PubMedCrossRef
55.
go back to reference Heiss WD, Sobesky J, Hesselmann V. Identifying thresholds for penumbra and irreversible tissue damage. Stroke. 2004;35(11 Suppl 1):2671–4.PubMedCrossRef Heiss WD, Sobesky J, Hesselmann V. Identifying thresholds for penumbra and irreversible tissue damage. Stroke. 2004;35(11 Suppl 1):2671–4.PubMedCrossRef
56.
go back to reference Hjort N, Butcher K, Davis SM, et al. Magnetic resonance imaging criteria for thrombolysis in acute cerebral infarct. Stroke. 2005;36(2):388–97.PubMedCrossRef Hjort N, Butcher K, Davis SM, et al. Magnetic resonance imaging criteria for thrombolysis in acute cerebral infarct. Stroke. 2005;36(2):388–97.PubMedCrossRef
57.
go back to reference Rohl L, Ostergaard L, Simonsen CZ, et al. Viability thresholds of ischemic penumbra of hyperacute stroke defined by perfusion-weighted MRI and apparent diffusion coefficient. Stroke. 2001;32(5):1140–6.PubMedCrossRef Rohl L, Ostergaard L, Simonsen CZ, et al. Viability thresholds of ischemic penumbra of hyperacute stroke defined by perfusion-weighted MRI and apparent diffusion coefficient. Stroke. 2001;32(5):1140–6.PubMedCrossRef
58.
go back to reference Zaro-Weber O, Moeller-Hartmann W, Heiss WD, Sobesky J. The performance of MRI-based cerebral blood flow measurements in acute and subacute stroke compared with 15O-water positron emission tomography. Identification of penumbral flow. Stroke. 40:2413-2421. Zaro-Weber O, Moeller-Hartmann W, Heiss WD, Sobesky J. The performance of MRI-based cerebral blood flow measurements in acute and subacute stroke compared with 15O-water positron emission tomography. Identification of penumbral flow. Stroke. 40:2413-2421.
59.
go back to reference Kalafut MA, Schriger DL, Saver JL, Starkman S. Detection of early CT signs of >1/3 middle cerebral artery infarctions: interrater reliability and sensitivity of CT interpretation by physicians involved in acute stroke care. Stroke. 2000;31(7):1667–71.PubMedCrossRef Kalafut MA, Schriger DL, Saver JL, Starkman S. Detection of early CT signs of >1/3 middle cerebral artery infarctions: interrater reliability and sensitivity of CT interpretation by physicians involved in acute stroke care. Stroke. 2000;31(7):1667–71.PubMedCrossRef
60.
go back to reference Pexman JH, Barber PA, Hill MD, et al. Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol. 2001;22(8):1534–42.PubMed Pexman JH, Barber PA, Hill MD, et al. Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol. 2001;22(8):1534–42.PubMed
61.
go back to reference Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score. Lancet. 2000;355(9216):1670–4.PubMedCrossRef Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score. Lancet. 2000;355(9216):1670–4.PubMedCrossRef
62.
go back to reference Dzialowski I, Hill MD, Coutts SB, et al. Extent of early ischemic changes on computed tomography (CT) before thrombolysis: prognostic value of the Alberta Stroke Program Early CT Score in ECASS II. Stroke. 2006;37(4):973–8.PubMedCrossRef Dzialowski I, Hill MD, Coutts SB, et al. Extent of early ischemic changes on computed tomography (CT) before thrombolysis: prognostic value of the Alberta Stroke Program Early CT Score in ECASS II. Stroke. 2006;37(4):973–8.PubMedCrossRef
63.
go back to reference Sillanpaa N, Saarinen JT, Rusanen H, et al. The clot burden score, the Boston Acute Stroke Imaging Scale, the cerebral blood volume ASPECTS, and two novel imaging parameters in the prediction of clinical outcome of ischemic stroke patients receiving intravenous thrombolytic therapy. Neuroradiology. 2011 (Epub ahead of print) Sillanpaa N, Saarinen JT, Rusanen H, et al. The clot burden score, the Boston Acute Stroke Imaging Scale, the cerebral blood volume ASPECTS, and two novel imaging parameters in the prediction of clinical outcome of ischemic stroke patients receiving intravenous thrombolytic therapy. Neuroradiology. 2011 (Epub ahead of print)
64.
go back to reference Madden KP, Karanjia PN, Adams Jr HP. Clarke WR. Accuracy of initial stroke subtype diagnosis in the TOAST study. Trial of ORG 10172 in Acute Stroke Treatment. Neurology. 1995;45(11):1975–9.PubMedCrossRef Madden KP, Karanjia PN, Adams Jr HP. Clarke WR. Accuracy of initial stroke subtype diagnosis in the TOAST study. Trial of ORG 10172 in Acute Stroke Treatment. Neurology. 1995;45(11):1975–9.PubMedCrossRef
65.
go back to reference Wardlaw JM, Dorman PJ, Lewis SC, Sandercock PA. Can stroke physicians and neuroradiologists identify signs of early cerebral infarction on CT? J Neurol Neurosurg Psychiatry. 1999;67(5):651–3.PubMedCrossRef Wardlaw JM, Dorman PJ, Lewis SC, Sandercock PA. Can stroke physicians and neuroradiologists identify signs of early cerebral infarction on CT? J Neurol Neurosurg Psychiatry. 1999;67(5):651–3.PubMedCrossRef
66.
go back to reference al. NSe. CT perfusion ASPECTS in the evaluation of acute ischemic stroke: thrombolytic therapy perspective. Cerebrovascular Diseases. 2011;1:6-16. al. NSe. CT perfusion ASPECTS in the evaluation of acute ischemic stroke: thrombolytic therapy perspective. Cerebrovascular Diseases. 2011;1:6-16.
67.
go back to reference Aviv RI, Mandelcorn J, Chakraborty S, et al. Alberta Stroke Program Early CT Scoring of CT perfusion in early stroke visualization and assessment. AJNR Am J Neuroradiol. 2007;28(10):1975–80. Nov-Dec.PubMedCrossRef Aviv RI, Mandelcorn J, Chakraborty S, et al. Alberta Stroke Program Early CT Scoring of CT perfusion in early stroke visualization and assessment. AJNR Am J Neuroradiol. 2007;28(10):1975–80. Nov-Dec.PubMedCrossRef
68.
go back to reference Kim JT, Park MS, Choi KH, et al. The CBV-ASPECT Score as a predictor of fatal stroke in a hyperacute state. Eur Neurol.63(6):357-363. Kim JT, Park MS, Choi KH, et al. The CBV-ASPECT Score as a predictor of fatal stroke in a hyperacute state. Eur Neurol.63(6):357-363.
69.
go back to reference Lin K, Rapalino O, Law M, Babb JS, Siller KA, Pramanik BK. Accuracy of the Alberta Stroke Program Early CT Score during the first 3 hours of middle cerebral artery stroke: comparison of noncontrast CT, CT angiography source images, and CT perfusion. AJNR Am J Neuroradiol. 2008;29(5):931–6.PubMedCrossRef Lin K, Rapalino O, Law M, Babb JS, Siller KA, Pramanik BK. Accuracy of the Alberta Stroke Program Early CT Score during the first 3 hours of middle cerebral artery stroke: comparison of noncontrast CT, CT angiography source images, and CT perfusion. AJNR Am J Neuroradiol. 2008;29(5):931–6.PubMedCrossRef
70.
go back to reference Schramm P, Schellinger PD, Fiebach JB, et al. Comparison of CT and CT angiography source images with diffusion-weighted imaging in patients with acute stroke within 6 hours after onset. Stroke. 2002;33(10):2426–32.PubMedCrossRef Schramm P, Schellinger PD, Fiebach JB, et al. Comparison of CT and CT angiography source images with diffusion-weighted imaging in patients with acute stroke within 6 hours after onset. Stroke. 2002;33(10):2426–32.PubMedCrossRef
71.
go back to reference Sharma M, Fox AJ, Symons S, Jairath A, Aviv RI. CT angiographic source images: flow- or volume-weighted? AJNR Am J Neuroradiol. Feb;32(2):359-364. Sharma M, Fox AJ, Symons S, Jairath A, Aviv RI. CT angiographic source images: flow- or volume-weighted? AJNR Am J Neuroradiol. Feb;32(2):359-364.
72.
go back to reference Hill MD, Coutts SB, Pexman JH, Demchuk AM. CTA source images in acute stroke. Stroke. 2003;34(4):835–7. author reply 835-837.PubMedCrossRef Hill MD, Coutts SB, Pexman JH, Demchuk AM. CTA source images in acute stroke. Stroke. 2003;34(4):835–7. author reply 835-837.PubMedCrossRef
73.
go back to reference Schaefer PW, Roccatagliata L, Ledezma C, et al. First-pass quantitative CT perfusion identifies thresholds for salvageable penumbra in acute stroke patients treated with intra-arterial therapy. AJNR Am J Neuroradiol. 2006;27(1):20–5.PubMed Schaefer PW, Roccatagliata L, Ledezma C, et al. First-pass quantitative CT perfusion identifies thresholds for salvageable penumbra in acute stroke patients treated with intra-arterial therapy. AJNR Am J Neuroradiol. 2006;27(1):20–5.PubMed
74.
go back to reference Simon JE, Bristow MS, Lu H, et al. A novel method to derive separate gray and white matter cerebral blood flow measures from MR imaging of acute ischemic stroke patients. J Cereb Blood Flow Metab. 2005;25(9):1236–43.PubMedCrossRef Simon JE, Bristow MS, Lu H, et al. A novel method to derive separate gray and white matter cerebral blood flow measures from MR imaging of acute ischemic stroke patients. J Cereb Blood Flow Metab. 2005;25(9):1236–43.PubMedCrossRef
75.
go back to reference Murphy BD, Fox AJ, Lee DH, et al. White matter thresholds for ischemic penumbra and infarct core in patients with acute stroke: CT perfusion study. Radiology. 2008;247(3):818–25.PubMedCrossRef Murphy BD, Fox AJ, Lee DH, et al. White matter thresholds for ischemic penumbra and infarct core in patients with acute stroke: CT perfusion study. Radiology. 2008;247(3):818–25.PubMedCrossRef
76.
go back to reference Murphy BD, Fox AJ, Lee DH, et al. Identification of penumbra and infarct in acute ischemic stroke using computed tomography perfusion-derived blood flow and blood volume measurements. Stroke. 2006;37(7):1771–7.PubMedCrossRef Murphy BD, Fox AJ, Lee DH, et al. Identification of penumbra and infarct in acute ischemic stroke using computed tomography perfusion-derived blood flow and blood volume measurements. Stroke. 2006;37(7):1771–7.PubMedCrossRef
77.
go back to reference Schaefer PW, Mui K, Kamalian S, Nogueira RG, Gonzalez RG, Lev MH. Avoiding "pseudo-reversibility" of CT-CBV infarct core lesions in acute stroke patients after thrombolytic therapy. The need for algorithmically "delay-corrected" CT perfusion map postprocessing software. Stroke. Aug;40(8):2875-8 Schaefer PW, Mui K, Kamalian S, Nogueira RG, Gonzalez RG, Lev MH. Avoiding "pseudo-reversibility" of CT-CBV infarct core lesions in acute stroke patients after thrombolytic therapy. The need for algorithmically "delay-corrected" CT perfusion map postprocessing software. Stroke. Aug;40(8):2875-8
78.
go back to reference Wintermark M, Flanders AE, Velthuis B, et al. Perfusion-CT assessment of infarct core and penumbra: receiver operating characteristic curve analysis in 130 patients suspected of acute hemispheric stroke. Stroke. 2006;37(4):979–85.PubMedCrossRef Wintermark M, Flanders AE, Velthuis B, et al. Perfusion-CT assessment of infarct core and penumbra: receiver operating characteristic curve analysis in 130 patients suspected of acute hemispheric stroke. Stroke. 2006;37(4):979–85.PubMedCrossRef
79.
go back to reference Sette G, Baron JC, Mazoyer B, Levasseur M, Pappata S, Crouzel C. Local brain haemodynamics and oxygen metabolism in cerebrovascular disease. Positron emission tomography. Brain. 1989;112(Pt 4):931–51.PubMedCrossRef Sette G, Baron JC, Mazoyer B, Levasseur M, Pappata S, Crouzel C. Local brain haemodynamics and oxygen metabolism in cerebrovascular disease. Positron emission tomography. Brain. 1989;112(Pt 4):931–51.PubMedCrossRef
80.
go back to reference Powers WJ, Grubb Jr RL, Raichle ME. Physiological responses to focal cerebral ischemia in humans. Ann Neurol. 1984;16(5):546–52.PubMedCrossRef Powers WJ, Grubb Jr RL, Raichle ME. Physiological responses to focal cerebral ischemia in humans. Ann Neurol. 1984;16(5):546–52.PubMedCrossRef
81.
go back to reference Kidwell CS, Saver JL, Mattiello J, et al. Thrombolytic reversal of acute human cerebral ischemic injury shown by diffusion/perfusion magnetic resonance imaging. Ann Neurol. 2000;47(4):462–9.PubMedCrossRef Kidwell CS, Saver JL, Mattiello J, et al. Thrombolytic reversal of acute human cerebral ischemic injury shown by diffusion/perfusion magnetic resonance imaging. Ann Neurol. 2000;47(4):462–9.PubMedCrossRef
82.
go back to reference d'Esterre CD, Aviv RI, Lee TY. The evolution of the cerebral bood volume abnormality in patients with inschemic stroke: a CT perfusion study. Acta Radiol. 2012;in press. d'Esterre CD, Aviv RI, Lee TY. The evolution of the cerebral bood volume abnormality in patients with inschemic stroke: a CT perfusion study. Acta Radiol. 2012;in press.
83.
go back to reference Silvennoinen HM, Hamberg LM, Lindsberg PJ, Valanne L, Hunter GJ. CT perfusion identifies increased salvage of tissue in patients receiving intravenous recombinant tissue plasminogen activator within 3 hours of stroke onset. AJNR Am J Neuroradiol. 2008;29(6):1118–23.PubMedCrossRef Silvennoinen HM, Hamberg LM, Lindsberg PJ, Valanne L, Hunter GJ. CT perfusion identifies increased salvage of tissue in patients receiving intravenous recombinant tissue plasminogen activator within 3 hours of stroke onset. AJNR Am J Neuroradiol. 2008;29(6):1118–23.PubMedCrossRef
84.
go back to reference Campbell BC, Christensen S, Levi CR, et al. Cerebral blood flow is the optimal CT perfusion parameter for assessing infarct core. Stroke. Dec;42(12):3435-3440. Campbell BC, Christensen S, Levi CR, et al. Cerebral blood flow is the optimal CT perfusion parameter for assessing infarct core. Stroke. Dec;42(12):3435-3440.
85.
go back to reference Kamalian S, Maas MB, Goldmacher GV, et al. CT cerebral blood flow maps optimally correlate with admission diffusion-weighted imaging in acute stroke but thresholds vary by postprocessing platform. Stroke. Jul;42(7):1923-1928. Kamalian S, Maas MB, Goldmacher GV, et al. CT cerebral blood flow maps optimally correlate with admission diffusion-weighted imaging in acute stroke but thresholds vary by postprocessing platform. Stroke. Jul;42(7):1923-1928.
86.
go back to reference Marchal G, Young AR, Baron JC. Early postischemic hyperperfusion: pathophysiologic insights from positron emission tomography. J Cereb Blood Flow Metab. 1999;19(5):467–82.PubMedCrossRef Marchal G, Young AR, Baron JC. Early postischemic hyperperfusion: pathophysiologic insights from positron emission tomography. J Cereb Blood Flow Metab. 1999;19(5):467–82.PubMedCrossRef
87.
go back to reference Butcher KS, Lee SB, Parsons MW, et al. Differential prognosis of isolated cortical swelling and hypoattenuation on CT in acute stroke. Stroke. 2007;38(3):941–7.PubMedCrossRef Butcher KS, Lee SB, Parsons MW, et al. Differential prognosis of isolated cortical swelling and hypoattenuation on CT in acute stroke. Stroke. 2007;38(3):941–7.PubMedCrossRef
88.
go back to reference Kidwell CS, Saver JL, Mattiello J, et al. Diffusion–perfusion MRI characterization of post-recanalization hyperperfusion in humans. Neurology. 2001;57(11):2015–21.PubMedCrossRef Kidwell CS, Saver JL, Mattiello J, et al. Diffusion–perfusion MRI characterization of post-recanalization hyperperfusion in humans. Neurology. 2001;57(11):2015–21.PubMedCrossRef
89.
go back to reference Murphy MJ, Tichauer KM, Sun L, Chen X, Lee TY. Mean transit time as an index of cerebral perfusion pressure in experimental systemic hypotension. Physiol Meas. Apr;32(4):395-405. Murphy MJ, Tichauer KM, Sun L, Chen X, Lee TY. Mean transit time as an index of cerebral perfusion pressure in experimental systemic hypotension. Physiol Meas. Apr;32(4):395-405.
90.
go back to reference Davis SM, Donnan GA, Parsons MW, et al. Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): a placebo-controlled randomised trial. Lancet Neurol. 2008;7(4):299–309.PubMedCrossRef Davis SM, Donnan GA, Parsons MW, et al. Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): a placebo-controlled randomised trial. Lancet Neurol. 2008;7(4):299–309.PubMedCrossRef
91.
go back to reference Zaro-Weber O, Moeller-Hartmann W, Heiss WD, Sobesky J. Maps of time to maximum and time to peak for mismatch definition in clinical stroke studies validated with positron emission tomography. Stroke. Dec;41(12):2817-2821. Zaro-Weber O, Moeller-Hartmann W, Heiss WD, Sobesky J. Maps of time to maximum and time to peak for mismatch definition in clinical stroke studies validated with positron emission tomography. Stroke. Dec;41(12):2817-2821.
92.
go back to reference The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333(24):1581–7.CrossRef The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333(24):1581–7.CrossRef
93.
go back to reference Hacke W, Albers G, Al-Rawi Y, et al. The Desmoteplase in Acute Ischemic Stroke Trial (DIAS): a phase II MRI-based 9-hour window acute stroke thrombolysis trial with intravenous desmoteplase. Stroke. 2005;36(1):66–73.PubMedCrossRef Hacke W, Albers G, Al-Rawi Y, et al. The Desmoteplase in Acute Ischemic Stroke Trial (DIAS): a phase II MRI-based 9-hour window acute stroke thrombolysis trial with intravenous desmoteplase. Stroke. 2005;36(1):66–73.PubMedCrossRef
94.
go back to reference Berger C, Fiorelli M, Steiner T, et al. Hemorrhagic transformation of ischemic brain tissue: asymptomatic or symptomatic? Stroke. 2001;32(6):1330–5.PubMedCrossRef Berger C, Fiorelli M, Steiner T, et al. Hemorrhagic transformation of ischemic brain tissue: asymptomatic or symptomatic? Stroke. 2001;32(6):1330–5.PubMedCrossRef
95.
go back to reference Molina CA, Alvarez-Sabin J, Montaner J, et al. Thrombolysis-related hemorrhagic infarction: a marker of early reperfusion, reduced infarct size, and improved outcome in patients with proximal middle cerebral artery occlusion. Stroke. 2002;33(6):1551–6.PubMedCrossRef Molina CA, Alvarez-Sabin J, Montaner J, et al. Thrombolysis-related hemorrhagic infarction: a marker of early reperfusion, reduced infarct size, and improved outcome in patients with proximal middle cerebral artery occlusion. Stroke. 2002;33(6):1551–6.PubMedCrossRef
96.
go back to reference Hacke W, Donnan G, Fieschi C, et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet. 2004;363(9411):768–74.PubMedCrossRef Hacke W, Donnan G, Fieschi C, et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet. 2004;363(9411):768–74.PubMedCrossRef
97.
go back to reference Dzialowski I, Pexman JH, Barber PA, Demchuk AM, Buchan AM, Hill MD. Asymptomatic hemorrhage after thrombolysis may not be benign: prognosis by hemorrhage type in the Canadian alteplase for stroke effectiveness study registry. Stroke. 2007;38(1):75–9.PubMedCrossRef Dzialowski I, Pexman JH, Barber PA, Demchuk AM, Buchan AM, Hill MD. Asymptomatic hemorrhage after thrombolysis may not be benign: prognosis by hemorrhage type in the Canadian alteplase for stroke effectiveness study registry. Stroke. 2007;38(1):75–9.PubMedCrossRef
98.
go back to reference Thomalla G, Sobesky J, Kohrmann M, et al. Two tales: hemorrhagic transformation but not parenchymal hemorrhage after thrombolysis is related to severity and duration of ischemia: MRI study of acute stroke patients treated with intravenous tissue plasminogen activator within 6 hours. Stroke. 2007;38(2):313–8.PubMedCrossRef Thomalla G, Sobesky J, Kohrmann M, et al. Two tales: hemorrhagic transformation but not parenchymal hemorrhage after thrombolysis is related to severity and duration of ischemia: MRI study of acute stroke patients treated with intravenous tissue plasminogen activator within 6 hours. Stroke. 2007;38(2):313–8.PubMedCrossRef
99.
go back to reference Montaner J, Molina CA, Monasterio J, et al. Matrix metalloproteinase-9 pretreatment level predicts intracranial hemorrhagic complications after thrombolysis in human stroke. Circulation. 2003;107(4):598–603.PubMedCrossRef Montaner J, Molina CA, Monasterio J, et al. Matrix metalloproteinase-9 pretreatment level predicts intracranial hemorrhagic complications after thrombolysis in human stroke. Circulation. 2003;107(4):598–603.PubMedCrossRef
100.
go back to reference Demchuk AM, Morgenstern LB, Krieger DW, et al. Serum glucose level and diabetes predict tissue plasminogen activator-related intracerebral hemorrhage in acute ischemic stroke. Stroke. 1999;30(1):34–9.PubMedCrossRef Demchuk AM, Morgenstern LB, Krieger DW, et al. Serum glucose level and diabetes predict tissue plasminogen activator-related intracerebral hemorrhage in acute ischemic stroke. Stroke. 1999;30(1):34–9.PubMedCrossRef
101.
go back to reference Montaner J. Stroke biomarkers: can they help us to guide stroke thrombolysis? Drug News Perspect. 2006;19(9):523–32.PubMedCrossRef Montaner J. Stroke biomarkers: can they help us to guide stroke thrombolysis? Drug News Perspect. 2006;19(9):523–32.PubMedCrossRef
102.
go back to reference Selim M, Fink JN, Kumar S, et al. Predictors of hemorrhagic transformation after intravenous recombinant tissue plasminogen activator: prognostic value of the initial apparent diffusion coefficient and diffusion-weighted lesion volume. Stroke. 2002;33(8):2047–52.PubMedCrossRef Selim M, Fink JN, Kumar S, et al. Predictors of hemorrhagic transformation after intravenous recombinant tissue plasminogen activator: prognostic value of the initial apparent diffusion coefficient and diffusion-weighted lesion volume. Stroke. 2002;33(8):2047–52.PubMedCrossRef
103.
go back to reference Knauer C, Knauer K, Muller S, et al. A biochemical marker panel in MRI-proven hyperacute ischemic stroke—a prospective study. BMC Neurol. Mar 8;12(1):14. Knauer C, Knauer K, Muller S, et al. A biochemical marker panel in MRI-proven hyperacute ischemic stroke—a prospective study. BMC Neurol. Mar 8;12(1):14.
104.
go back to reference Kawano H, Hirano T, Nakajima M, Inatomi Y, Yonehara T, Uchino M. Modified ASPECTS for DWI including deep white matter lesions predicts subsequent intracranial hemorrhage. J Neurol. Feb 17 2012. (in press) Kawano H, Hirano T, Nakajima M, Inatomi Y, Yonehara T, Uchino M. Modified ASPECTS for DWI including deep white matter lesions predicts subsequent intracranial hemorrhage. J Neurol. Feb 17 2012. (in press)
105.
go back to reference Dankbaar JW, Hom J, Schneider T, et al. Dynamic perfusion CT assessment of the blood–brain barrier permeability: first pass versus delayed acquisition. AJNR Am J Neuroradiol. 2008;29(9):1671–6.PubMedCrossRef Dankbaar JW, Hom J, Schneider T, et al. Dynamic perfusion CT assessment of the blood–brain barrier permeability: first pass versus delayed acquisition. AJNR Am J Neuroradiol. 2008;29(9):1671–6.PubMedCrossRef
106.
go back to reference Lin K. Predicting transformation to type 2 parenchymal hematoma in acute ischemic stroke by CT permeability imaging. AJNR Am J Neuroradiol. Jun-Jul;32(6):E124; author reply E125. Lin K. Predicting transformation to type 2 parenchymal hematoma in acute ischemic stroke by CT permeability imaging. AJNR Am J Neuroradiol. Jun-Jul;32(6):E124; author reply E125.
107.
go back to reference Sachdev P, Chen X, Wen W. White matter hyperintensities in mid-adult life. Curr Opin Psychiatry. 2008;21(3):268–74.PubMedCrossRef Sachdev P, Chen X, Wen W. White matter hyperintensities in mid-adult life. Curr Opin Psychiatry. 2008;21(3):268–74.PubMedCrossRef
108.
go back to reference Murray AD, Staff RT, Shenkin SD, Deary IJ, Starr JM, Whalley LJ. Brain white matter hyperintensities: relative importance of vascular risk factors in nondemented elderly people. Radiology. 2005;237(1):251–7.PubMedCrossRef Murray AD, Staff RT, Shenkin SD, Deary IJ, Starr JM, Whalley LJ. Brain white matter hyperintensities: relative importance of vascular risk factors in nondemented elderly people. Radiology. 2005;237(1):251–7.PubMedCrossRef
109.
go back to reference Laslo AM, Eastwood JD, Pakkiri P, Chen F, Lee TY. CT perfusion-derived mean transit time predicts early mortality and delayed vasospasm after experimental subarachnoid hemorrhage. AJNR Am J Neuroradiol. 2008;29(1):79–85.PubMedCrossRef Laslo AM, Eastwood JD, Pakkiri P, Chen F, Lee TY. CT perfusion-derived mean transit time predicts early mortality and delayed vasospasm after experimental subarachnoid hemorrhage. AJNR Am J Neuroradiol. 2008;29(1):79–85.PubMedCrossRef
110.
go back to reference Brilstra EH, Rinkel GJ, Algra A, van Gijn J. Rebleeding, secondary ischemia, and timing of operation in patients with subarachnoid hemorrhage. Neurology. 2000;55(11):1656–60.PubMedCrossRef Brilstra EH, Rinkel GJ, Algra A, van Gijn J. Rebleeding, secondary ischemia, and timing of operation in patients with subarachnoid hemorrhage. Neurology. 2000;55(11):1656–60.PubMedCrossRef
111.
go back to reference Sloan MA, Haley Jr EC, Kassell NF, et al. Sensitivity and specificity of transcranial Doppler ultrasonography in the diagnosis of vasospasm following subarachnoid hemorrhage. Neurology. 1989;39(11):1514–8.PubMedCrossRef Sloan MA, Haley Jr EC, Kassell NF, et al. Sensitivity and specificity of transcranial Doppler ultrasonography in the diagnosis of vasospasm following subarachnoid hemorrhage. Neurology. 1989;39(11):1514–8.PubMedCrossRef
112.
go back to reference Reilly C, Amidei C, Tolentino J, Jahromi BS, Macdonald RL. Clot volume and clearance rate as independent predictors of vasospasm after aneurysmal subarachnoid hemorrhage. J Neurosurg. 2004;101(2):255–61.PubMedCrossRef Reilly C, Amidei C, Tolentino J, Jahromi BS, Macdonald RL. Clot volume and clearance rate as independent predictors of vasospasm after aneurysmal subarachnoid hemorrhage. J Neurosurg. 2004;101(2):255–61.PubMedCrossRef
113.
go back to reference Harrigan MR, Magnano CR, Guterman LR, Hopkins LN. Computed tomographic perfusion in the management of aneurysmal subarachnoid hemorrhage: new application of an existent technique. Neurosurgery. 2005;56(2):304–17. discussion 304-317.PubMedCrossRef Harrigan MR, Magnano CR, Guterman LR, Hopkins LN. Computed tomographic perfusion in the management of aneurysmal subarachnoid hemorrhage: new application of an existent technique. Neurosurgery. 2005;56(2):304–17. discussion 304-317.PubMedCrossRef
114.
go back to reference Wintermark M, Ko NU, Smith WS, Liu S, Higashida RT, Dillon WP. Vasospasm after subarachnoid hemorrhage: utility of perfusion CT and CT angiography on diagnosis and management. AJNR Am J Neuroradiol. 2006;27(1):26–34.PubMed Wintermark M, Ko NU, Smith WS, Liu S, Higashida RT, Dillon WP. Vasospasm after subarachnoid hemorrhage: utility of perfusion CT and CT angiography on diagnosis and management. AJNR Am J Neuroradiol. 2006;27(1):26–34.PubMed
115.
go back to reference Nogueira RG, Lev MH, Roccatagliata L, et al. Intra-arterial nicardipine infusion improves CT perfusion-measured cerebral blood flow in patients with subarachnoid hemorrhage-induced vasospasm. AJNR Am J Neuroradiol. 2009;30(1):160–4.PubMedCrossRef Nogueira RG, Lev MH, Roccatagliata L, et al. Intra-arterial nicardipine infusion improves CT perfusion-measured cerebral blood flow in patients with subarachnoid hemorrhage-induced vasospasm. AJNR Am J Neuroradiol. 2009;30(1):160–4.PubMedCrossRef
116.
go back to reference Broderick JP, Brott TG, Duldner JE, Tomsick T, Huster G. Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality. Stroke. 1993;24(7):987–93.PubMedCrossRef Broderick JP, Brott TG, Duldner JE, Tomsick T, Huster G. Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality. Stroke. 1993;24(7):987–93.PubMedCrossRef
117.
go back to reference Sacco S, Marini C, Toni D, Olivieri L, Carolei A. Incidence and 10-year survival of intracerebral hemorrhage in a population-based registry. Stroke. 2009;40(2):394–9.PubMedCrossRef Sacco S, Marini C, Toni D, Olivieri L, Carolei A. Incidence and 10-year survival of intracerebral hemorrhage in a population-based registry. Stroke. 2009;40(2):394–9.PubMedCrossRef
118.
go back to reference Sudlow CL, Warlow CP. Comparable studies of the incidence of stroke and its pathological types: results from an international collaboration. International Stroke Incidence Collaboration. Stroke. 1997;28(3):491–9.PubMedCrossRef Sudlow CL, Warlow CP. Comparable studies of the incidence of stroke and its pathological types: results from an international collaboration. International Stroke Incidence Collaboration. Stroke. 1997;28(3):491–9.PubMedCrossRef
119.
go back to reference van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol. Feb;9(2):167-176. van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol. Feb;9(2):167-176.
120.
go back to reference Fewel ME, Thompson Jr BG, Hoff JT. Spontaneous intracerebral hemorrhage: a review. Neurosurg Focus. 2003;15(4):E1. Oct 15.PubMed Fewel ME, Thompson Jr BG, Hoff JT. Spontaneous intracerebral hemorrhage: a review. Neurosurg Focus. 2003;15(4):E1. Oct 15.PubMed
121.
go back to reference Romero JM, Heit JJ, Delgado Almandoz JE, et al. Spot sign score predicts rapid bleeding in spontaneous intracerebral hemorrhage. Emerg Radiol. Jan 22. Romero JM, Heit JJ, Delgado Almandoz JE, et al. Spot sign score predicts rapid bleeding in spontaneous intracerebral hemorrhage. Emerg Radiol. Jan 22.
122.
go back to reference Kidwell CS, Saver JL, Mattiello J, et al. Diffusion–perfusion MR evaluation of perihematomal injury in hyperacute intracerebral hemorrhage. Neurology. 2001;57(9):1611–7.PubMedCrossRef Kidwell CS, Saver JL, Mattiello J, et al. Diffusion–perfusion MR evaluation of perihematomal injury in hyperacute intracerebral hemorrhage. Neurology. 2001;57(9):1611–7.PubMedCrossRef
123.
go back to reference Fainardi E, Borrelli M, Saletti A, et al. CT perfusion mapping of hemodynamic disturbances associated to acute spontaneous intracerebral hemorrhage. Neuroradiology. 2008;50(8):729–40.PubMedCrossRef Fainardi E, Borrelli M, Saletti A, et al. CT perfusion mapping of hemodynamic disturbances associated to acute spontaneous intracerebral hemorrhage. Neuroradiology. 2008;50(8):729–40.PubMedCrossRef
124.
go back to reference Rosand J, Eskey C, Chang Y, Gonzalez RG, Greenberg SM, Koroshetz WJ. Dynamic single-section CT demonstrates reduced cerebral blood flow in acute intracerebral hemorrhage. Cerebrovasc Dis. 2002;14(3–4):214–20.PubMedCrossRef Rosand J, Eskey C, Chang Y, Gonzalez RG, Greenberg SM, Koroshetz WJ. Dynamic single-section CT demonstrates reduced cerebral blood flow in acute intracerebral hemorrhage. Cerebrovasc Dis. 2002;14(3–4):214–20.PubMedCrossRef
125.
go back to reference Herweh C, Juttler E, Schellinger PD, Klotz E, Schramm P. Perfusion CT in hyperacute cerebral hemorrhage within 3 hours after symptom onset: is there an early perihemorrhagic penumbra? J Neuroimaging. Oct;20(4):350-353. Herweh C, Juttler E, Schellinger PD, Klotz E, Schramm P. Perfusion CT in hyperacute cerebral hemorrhage within 3 hours after symptom onset: is there an early perihemorrhagic penumbra? J Neuroimaging. Oct;20(4):350-353.
126.
go back to reference Butcher KS, Baird T, MacGregor L, Desmond P, Tress B, Davis S. Perihematomal edema in primary intracerebral hemorrhage is plasma derived. Stroke. 2004;35(8):1879–85.PubMedCrossRef Butcher KS, Baird T, MacGregor L, Desmond P, Tress B, Davis S. Perihematomal edema in primary intracerebral hemorrhage is plasma derived. Stroke. 2004;35(8):1879–85.PubMedCrossRef
127.
go back to reference Broderick JP, Diringer MN, Hill MD, et al. Determinants of intracerebral hemorrhage growth: an exploratory analysis. Stroke. 2007;38(3):1072–5.PubMedCrossRef Broderick JP, Diringer MN, Hill MD, et al. Determinants of intracerebral hemorrhage growth: an exploratory analysis. Stroke. 2007;38(3):1072–5.PubMedCrossRef
128.
go back to reference Kazui S, Naritomi H, Yamamoto H, Sawada T, Yamaguchi T. Enlargement of spontaneous intracerebral hemorrhage. Incidence and time course. Stroke. 1996;27(10):1783–7.PubMedCrossRef Kazui S, Naritomi H, Yamamoto H, Sawada T, Yamaguchi T. Enlargement of spontaneous intracerebral hemorrhage. Incidence and time course. Stroke. 1996;27(10):1783–7.PubMedCrossRef
129.
go back to reference Mayer SA, Brun NC, Begtrup K, et al. Efficacy and safety of recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med. 2008;358(20):2127–37.PubMedCrossRef Mayer SA, Brun NC, Begtrup K, et al. Efficacy and safety of recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med. 2008;358(20):2127–37.PubMedCrossRef
130.
go back to reference Mayer SA, Davis SM, Skolnick BE, et al. Can a subset of intracerebral hemorrhage patients benefit from hemostatic therapy with recombinant activated factor VII? Stroke. 2009;40(3):833–40.PubMedCrossRef Mayer SA, Davis SM, Skolnick BE, et al. Can a subset of intracerebral hemorrhage patients benefit from hemostatic therapy with recombinant activated factor VII? Stroke. 2009;40(3):833–40.PubMedCrossRef
131.
go back to reference Kim J, Smith A, Hemphill 3rd JC, et al. Contrast extravasation on CT predicts mortality in primary intracerebral hemorrhage. AJNR Am J Neuroradiol. 2008;29(3):520–5.PubMedCrossRef Kim J, Smith A, Hemphill 3rd JC, et al. Contrast extravasation on CT predicts mortality in primary intracerebral hemorrhage. AJNR Am J Neuroradiol. 2008;29(3):520–5.PubMedCrossRef
132.
go back to reference Wada R, Aviv RI, Fox AJ, et al. CT angiography "spot sign" predicts hematoma expansion in acute intracerebral hemorrhage. Stroke. 2007;38(4):1257–62.PubMedCrossRef Wada R, Aviv RI, Fox AJ, et al. CT angiography "spot sign" predicts hematoma expansion in acute intracerebral hemorrhage. Stroke. 2007;38(4):1257–62.PubMedCrossRef
133.
go back to reference Becker KJ, Baxter AB, Bybee HM, Tirschwell DL, Abouelsaad T, Cohen WA. Extravasation of radiographic contrast is an independent predictor of death in primary intracerebral hemorrhage. Stroke. 1999;30(10):2025–32.PubMedCrossRef Becker KJ, Baxter AB, Bybee HM, Tirschwell DL, Abouelsaad T, Cohen WA. Extravasation of radiographic contrast is an independent predictor of death in primary intracerebral hemorrhage. Stroke. 1999;30(10):2025–32.PubMedCrossRef
134.
go back to reference Goldstein JN, Fazen LE, Snider R, et al. Contrast extravasation on CT angiography predicts hematoma expansion in intracerebral hemorrhage. Neurology. 2007;68(12):889–94.PubMedCrossRef Goldstein JN, Fazen LE, Snider R, et al. Contrast extravasation on CT angiography predicts hematoma expansion in intracerebral hemorrhage. Neurology. 2007;68(12):889–94.PubMedCrossRef
135.
go back to reference Delgado Almandoz JE, Yoo AJ, Stone MJ, et al. The spot sign score in primary intracerebral hemorrhage identifies patients at highest risk of in-hospital mortality and poor outcome among survivors. Stroke. 2010;41(1):54–60.PubMedCrossRef Delgado Almandoz JE, Yoo AJ, Stone MJ, et al. The spot sign score in primary intracerebral hemorrhage identifies patients at highest risk of in-hospital mortality and poor outcome among survivors. Stroke. 2010;41(1):54–60.PubMedCrossRef
Metadata
Title
Improving Acute Stroke Management with Computed Tomography Perfusion: A Review of Imaging Basics and Applications
Authors
C. D. d’Esterre
Enrico Fainardi
R. I. Aviv
T. Y. Lee
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
Translational Stroke Research / Issue 2/2012
Print ISSN: 1868-4483
Electronic ISSN: 1868-601X
DOI
https://doi.org/10.1007/s12975-012-0178-5

Other articles of this Issue 2/2012

Translational Stroke Research 2/2012 Go to the issue