Background CT perfusion is used routinely in the acute management of stroke. Core infarct size on perfusion studies affects endovascular management decisions. The literature on correlation of core infarct with follow-up imaging is limited.
Objectives To assess the correlation of core infarct on CT perfusion with follow-up imaging.
Methods Retrospective chart review was performed between 2009 and 2010 of 31 patients who had CT perfusion (CTP) studies and follow-up imaging. Persistence of CTP core infarct with follow-up imaging (CT head or MRI brain) was assessed.
Results 71.8% of patients (n=23) had correlating infarcts on initial CTP and follow-up imaging. 18.8% of patients (n=6) had Penumbra on CTP correlating with infarct on follow-up imaging. 6.2% of patients (n=2) had negative CTP but with appearance of infarct on follow-up imaging. One patient (3.1%) had an infarct on CTP with no infarct seen on follow-up imaging. Based on above analysis sensitivity and specificity of CTP based studies predicting core infarct are 92% and 85% respectively.
Conclusions CTP core infarct size correlates with changes consistent with infarction on follow-up imaging (CT, MRI). Furthermore our study demonstrates that penumbra on CTP correlates well with tissue at risk demonstrated by appearance of infarct on follow-up imaging in the same territory. Further studies with larger sample size are warranted to evaluate the role of CTP in assessing core infarct.
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