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1、3D Blood Volume Imaging Acute Ischemic Stroke,Kuncheng Li M.D.,Ph.D.,Medical Imaging CenterDepartment of Radiology Xuanwu Hospital Capital Medical UniversityBeijing 100053 China,Non-enhanced CT(NECT):could exclude hemorrhage and indicate early signs of ischemic strokePerfusion CT(PCT):shows hemodyna
2、mic statusCT angiography(CTA):shows vascular occlusion location,Comprehensive Imaging in 15 Minutes,Perfusion CT,Images from PCT:MIPCBFCBVTTP,BUT:limited coverage,Whole brain perfusionis ideal!,Calculating 3D-PBV Images,CTA,low pass filtering,NECT,Registration,uses information,3D PBV,Skull,Bones,CSF
3、,Bones,Vessels,Pre-Studiesof 3D-PBV,Materials 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 symptomsNECT,CTA and CTP were performed within an average time of 2.
4、8 hours(range 1-6 hours)after onset of symptomsIntravenous 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 vertex reconstruct with 5/1mm
5、 slice thickness CTP:dynamic scan 3 adjacent slices(28.8 mm thickness)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/sec,CT Scan Protocol,Results,NECT:signs of ischemia were demonstrated in 13 of 25 acute stroke patien
6、tsCTP:CBF,CBV,and TTP demonstrated perfusion deficits in 21 patients CBF,CBV,and TTP demonstrated suspected perfusion deficits in 2 patients Only TTP demonstrated perfusion deficits in 2 of 25 patients3D-PBV:demonstrated perfusion deficits in all of the 25 acute stroke patients,3D-PBV has a higher d
7、etection rate for infarct lesion than NECT and CTP,and can depict the whole infarction lesion,Results,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 C
8、T(R=0.837,P0.001),Volume cm3,R=0.776P0.001,R=0.723P0.001,R=0.629P=0.001,R=0.837P0.001,CBF-follow-up CT,CBV-follow-up CT,TTP-follow-up CT,PBV-follow-up CT,Results,Thrombolysis Group,CTP:the lesion volume significantly correlated with the follow-up plain CT CBF R=0.811,P0.001 CBV R=0.829,P0.001 TTP R=
9、0.807,P0.001PBV:the lesion volume significantly correlated with the follow-up plain CT R=0.851,P0.001,Thrombolysis Group,R=0.755P=0.007,PBV-follow-up CT,CBF-follow-up CT,CBV-follow-up CT,TTP-follow-up CT,R=0.851P0.001,R=0.811P0.001,R=0.829P0.001,R=0.807P0.001,Conclusions,3D PBV can improve detection
10、 rate of ischemia by avoiding lesion omitting and assess the full extent of ischemia which correlates well with follow-up plain CT3D PBV requires no additional scan or contrast injection and can be performed in a short period of time.The integration of 3D-PBV with multimodal CT(NECT,CTP and CTA)can
11、add the diagnostic value in acute ischemic stroke,TEXT,NECT,CTA,CTP,3D-PBV,Acute Ischemic Stroke New Multimodal CT Protocol,Jie Lu M.D.,Ph.D.Miao Zhang M.D.Xiangying Du M.D.,Ph.D.Yan Gao M.D.Yunyun Duan M.D.Yanxiang Cao M.D.Xin Sui M.D.,Acknowledgments,Siemens Ltd.,ChinaJiu-hong Chen Ph,D.Reto D.Merges,
