Initial experience of 128 slices 4DCT whole brain perfusion imaging in acute cerebral infarction

Objective:To evaluate the initial experience of 128 slices 4DCT whole brain perfusion imaging in acute cerebral infarction.Methods: Conventional plain CT and CT perfusion were performed on 30 patients with acute cerebral infarction within 24 hours after onset.The sensitivity of the plain CT scan and whole-brain perfusion CT for the ischemic focus was compared.Quantitative analysis of cerebral perfusion parameters were carried out on perfusion images.CT angiography was reconstructed with dynamic cerebral perfusion images as source images to evaluate occlusion or stenosis of intracalvarium blood vessel.Results: Twenty patients with convertional plain CT were enrolled,and 5 cases were found early infarction,and 15 cases revealed normal.Eight ischemic foci were found in plain CT scan,while 14 ischemic areas were found in whole-brain perfusion CT.Cerebral blood flow(CBF),and cerebral blood volume(CBV) were decreased,delayed time to peak(TTP) and mean transit time(MTT) was delayed.The side of ischemic lesion as compared with the opposite,and the core of ischemic lesion as compared with peripheral zone were found to have changed significantly(P0.05).Twenty cases CT angiography revealed intracranial arterial stenosis or occlusion.Among them 6 cases had left middle cerebral artery occlusion or stenosis,5 cases had middle right cerebral artery stenosis and 4 cases had right anterior cerebral artery stenosis.Conclusion: By whole-brain perfusion CT with 128 slice 4DCT system with administration of one contrast medium bolus,whole-brain perfusion image CTA source and plain CT images can be achieved.Dates can improve detection rate of ischemia by avoiding omission of lesions and assess the full extent of ischemia that correlates well with the follow-up infarct.