Automated Brain Perfusion Imaging in Acute Ischemic Stroke: Interpretation Pearls and Pitfalls

Maybe there is something in here to 100% recovery but it's not obvious to me.

Automated Brain Perfusion Imaging in Acute Ischemic Stroke: Interpretation Pearls and Pitfalls

 

Manal Nicolas-Jilwan

,

Max Wintermark

Originally published27 Sep 2021https://doi.org/10.1161/STROKEAHA.121.035049Stroke. ;0:STROKEAHA.121.035049

Abstract

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.

Footnotes

For Sources of Funding and Disclosures, see page xxx.

Correspondence to: Manal Nicolas-Jilwan, MD, Department of Radiology (MBC-28), King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia 11211. Email manaljilwan@hotmail.com