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PubMed · 15221155

Cerebral perfusion impairment correlates with the decrease of CT density in acute ischaemic stroke.

Thomas Kucinski·Amitava Majumder·René Knab·Dirk Naumann·Jens Fiehler·Ole Väterlein·Bernd Eckert·Joachim Röther·Hermann Zeumer
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Abstract

Within the first 6 h of ischaemic stroke, changes on computed tomography (CT) scans are known as early ischaemic signs. We tested the hypothesis that the severity of perfusion impairment correlates with the degree of CT density decrease. Water uptake in ischaemic brain tissue results in a subtle decrease of CT density, and was quantified by delineation of the corresponding decrease of the apparent diffusion coefficient (ADC). Regions of decreased ADC and CT density in 29 acute-stroke patients were superimposed on the corresponding magnetic resonance perfusion images. Mean values of ADC and CT density decrease were correlated with the corresponding relative changes of cerebral blood flow (rCBF) and volume (rCBV), mean transit time (rMTT) and time-to-peak (rTTP). The decrease of CT density was 1.2 +/- 0.6 Hounsfield units and showed a linear correlation with rCBF (0.42, p < 0.01) as well as rCBV (0.62, p < 0.01), but not with the prolongation of rMTT (1.43, p = 0.78) or rTTP (1.34, p = 0.26). Therefore, the reduction of rCBF determines the severity of the early ischaemic oedema (EIOE) on CT, as well as reduction of the ADC. These findings provide a coherent view on the pathophysiology of the EIOE.

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AdultAgedAged, 80 and overBlood Flow VelocityBlood VolumeBrain IschemiaCerebrovascular CirculationContrast MediaDiffusionDiffusion Magnetic Resonance ImagingFemaleHumansMaleMiddle AgedRetrospective StudiesStrokeTomography, X-Ray ComputedJournal ArticleResearch Support, Non-U.S. Gov't

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Thomas Kucinski, Amitava Majumder, René Knab, Dirk Naumann, Jens Fiehler, Ole Väterlein, Bernd Eckert, Joachim Röther, Hermann Zeumer. 2004. Cerebral perfusion impairment correlates with the decrease of CT density in acute ischaemic stroke.. https://doi.org/10.1007/s00234-004-1226-y

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