CT Perfusion

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Interpretation

  • Infarct: Increased MTT, decreased CBF, decreased CBV
  • Penumbra: Increased MTT, decreased CBF, maintained CBV
  • Good reference article for CT Perfusion StrokeCT.pdf

Ctperfusion.jpg

From Radiographics article above.

  • MTT/TTP most sensitive, but least specific. Can look here first for subtle abnormalities, then see if real on CBV/CBF (CBF most spec).
  • decreased CBV = correlate of restricted diffusion on MRI
  • If no abnormal CBV, but decreased CBF then hypoperfused without infarct (e.g. high grade stenosis).