CT perfusion in acute stroke: Know the mimics, potential pitfalls, artifacts, and technical errors
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The CT perfusion (CTP) imaging of brain has been established as a clinically useful tool in multimodality imaging of acute stroke. All abnormalities seen on perfusion CT are not specifically related to acute infarct. There are many neurologic diseases causing symptoms simulating cerebrovascular disease produce an alteration of brain perfusion and thus can result in perfusion CT abnormalities. There are many pitfalls and artifacts in acquiring the data, calculation of maps and choosing arterial input function. We analyze and classify all these aspects, to allow the technician and the radiologist to know exactly what to avoid and what to choose, and we indicate the way to improve the quality of examination. The knowledge of mimics and pitfalls in acute stroke imaging can be helpful in accurate interpretation of these examinations.
KeywordsCT perfusion Acute stroke Technical pitfalls
Cerebral blood volume
Mean transit time
Cerebral blood flow
Anterior cerebral artery
Middle cerebral artery
Internal carotid artery
The authors are grateful to Sarah Peangatelli, Radiology Graphics Imaging Specialist for providing assistant with images.
Conflict of interest
The authors declare that they have no conflict of interest.
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