Added value of CT perfusion and CT angiography in detection of early ischemic stroke: Comparison with noncontrast CT

The purpose of this study was to determine whether PCT and CTA increase the sensitivity of NCT in early diagnosis of acute ischemic stroke. Sixty-four patients of acute stroke were retrospectively evaluated with respect to early CT findings. This included findings on noncontrast CT, perfusion defects and angiographic findings of vascular occlusion. Inclusion criteria comprised a clinical and radiological diagnosis of ischemic stroke based on clinical data and the presence of infarction in follow-up MRI scans done 12–24 h after the onset of the neurologic deficit. CT perfusion showed evidence of cerebral hypo-perfusion in the form of prolonged MTT and decreased CBF in all stroke cases giving 100% sensitivity. The CBV was decreased in only 24 cases and was normal in 24 cases and increased in 16 cases. Analysis of the CTA revealed artery occlusion in 55 (86%) cases, while it was normal in 8 (12.5%) cases. CT perfusion and CTA provide effective diagnostic tools in acute stroke with increased sensitivity to detect acute cerebral ischemia compared with noncontrast CT alone.