Automated Brain Perfusion Imaging in Acute Ischemic Stroke: Interpretation Pearls and Pitfalls.
Manal Nicolas-JilwanMax WintermarkPublished in: Stroke (2021)
Recent advancements in computed tomography technology, including improved brain coverage and automated processing of the perfusion data, have reinforced the use of perfusion computed tomography imaging in the routine evaluation of patients with acute ischemic stroke. The DAWN (Diffusion Weighted Imaging or Computerized Tomography Perfusion Assessment With Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention) and DEFUSE 3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3) trials have established the benefit of endovascular thrombectomy in patients with acute ischemic stroke with anterior circulation large vessel occlusion up to 24 hours of last seen normal, using perfusion imaging-based patient selection. The compelling data has prompted stroke centers to increasingly introduce automated perfusion computed tomography imaging in the routine evaluation of patients with acute ischemic stroke. We present a comprehensive overview of the acquisition and interpretation of automated perfusion imaging in patients with acute ischemic stroke with a special emphasis on the interpretation pearls, pitfalls, and stroke mimicking conditions.
Keyphrases
- acute ischemic stroke
- contrast enhanced
- computed tomography
- high resolution
- magnetic resonance imaging
- machine learning
- deep learning
- high throughput
- emergency department
- diffusion weighted imaging
- positron emission tomography
- stem cells
- healthcare
- electronic health record
- magnetic resonance
- white matter
- cerebral ischemia
- resting state
- case report
- blood brain barrier
- functional connectivity
- cell therapy
- dual energy
- clinical decision support
- subarachnoid hemorrhage
- bone marrow