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Comparison of 64-row and 16-row multidetector CT in the perfusion CT evaluation of acute ischemic stroke patients receiving intravenous thrombolytic therapy

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Introduction

Perfusion computed tomography (PCT) is increasingly performed in multimodal CT evaluation of acute ischemic stroke. We compared the technical quality of perfusion studies performed with a 16-row and a 64-row scanner and analyzed the differences between the scanners in their ability to detect perfusion defects.

Methods

We analyzed retrospectively the clinical and imaging data of 140 consecutive acute (<3 h) stroke patients who underwent multimodal CT evaluation and received intravenous rtPA. Alberta Stroke Program Early CT Score (ASPECTS) was assigned to PCT maps. Clinical and imaging parameters were compared between the two scanners.

Results

There were more motion artifacts in the 16-row studies (p = 0.04), and the analysis software was able to completely correct significantly fewer of these (p < 0.001). Both ASPECTS levels were optimally covered in only 29% of the 16-row studies, whereas in the 64-row studies, both levels were invariably optimally visualized (p < 0.001). This significantly decreased the sensitivity of the 16-row scanner to detect perfusion defects in the upper ASPECTS level (p = 0.02). The 64-row scanner was able to detect more perfusion defects that were located entirely outside the ASPECTS regions (p = 0.03). There was no significant difference in the 3-month functional outcome.

Conclusions

The 16-row scanner suffered from limited anatomic coverage that decreased the sensitivity to detect perfusion defects in the cranial parts of the middle cerebral artery region. The 16-row studies had poorer technical quality that was in part attributable to higher sampling frequency and smaller slice thickness making the imaging more sensitive to small-scale movement of the patient.

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Abbreviations

AIF:

Arterial input function

ASPECTS:

Alberta Stroke Program Early CT Score

CBV:

Cerebral blood volume

MCA:

Middle cerebral artery

MRI:

Magnetic resonance imaging

MTT:

Mean transit time

NCCT:

Non-contrast-enhanced computed tomography

NIHSS:

National Institutes of Health Stroke Scale

mRS:

Modified Rankin Scale

PCT:

Perfusion computed tomography

rtPA:

Recombinant tissue plasminogen activator

VOF:

Venous output function

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Acknowledgments

This study was supported by the Tampere University Hospital governmental subsidiary (EVO) funds for clinical research.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Medical Imaging Centre, Tampere University Hospital, PL 2000, 33521, Tampere, Finland

    Niko Sillanpaa, Prasun Dastidar & Seppo Soimakallio

  2. Department of Neurology, Oulu University Hospital, Oulu, Finland

    Harri Rusanen

  3. Department of Neurology, Tampere University Hospital, Tampere, Finland

    Jukka T. Saarinen

Authors
  1. Niko Sillanpaa
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  2. Harri Rusanen
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  3. Jukka T. Saarinen
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  4. Prasun Dastidar
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  5. Seppo Soimakallio
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Corresponding author

Correspondence to Niko Sillanpaa.

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Sillanpaa, N., Rusanen, H., Saarinen, J.T. et al. Comparison of 64-row and 16-row multidetector CT in the perfusion CT evaluation of acute ischemic stroke patients receiving intravenous thrombolytic therapy. Neuroradiology 54, 957–963 (2012). https://doi.org/10.1007/s00234-012-1015-y

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  • DOI: https://doi.org/10.1007/s00234-012-1015-y

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