Computed Tomography Perfusion Imaging Quality Affected by Different Input Arteries in Patients of Internal Carotid Artery Stenosis

Abstract

BackgroundThe aim of this study was to explore the influence of different input arteries on the parameters of computed tomography (CT) perfusion imaging for patients with different degree of stenosis of internal carotid artery (ICA).Material/MethodsForty patients were enrolled in the present study and divided into mild, moderate, severe stenosis and occlusion groups respectively with each 10 patients in each group. In reconstruction of cerebral CT perfusion (CTP) images, each raw perfusion image was reconstructed 3 times based on different reference input artery, including bilateral middle cerebral artery (MCA) and basilar arteries (BA). Region of interest (ROI) was drawn in the central territories of bilateral anterior cerebral artery, middle cerebral artery and posterior cerebral artery. And regional cerebral blood flow (rCBF) regional cerebral blood volume (rCBV), mean transit time (MTT), time to peak (TTP) and delay time (DT) were obtained from those ROI corresponding perfusion images.ResultsIn patients with mild and moderate ICA stenosis, there was no significant difference of perfusion parameters based on different input arteries (P>0.05). However, in severe ICA stenosis and occlusion CBF, MTT, and DT were significant different in affect side of the MCA group compared to the others (P<0.05).ConclusionsLarge intracranial artery can be selected as the input artery for patients with mild to moderate ICA stenosis, while for patients with severe stenosis and occlusion of ICA, the contra lateral middle cerebral artery or basilar artery would be better choice.

CT Perfusion as a Predictor of the Final Infarct Volume in Patients with Tandem Occlusion

“…Such parameters grossly rely upon the time–density curves generated by the scanning contrast bolus passage in different arterial vessels [ 45 , 46 , 47 ]. AIF location is crucial to allow the correct comparison between perfusion parameters of the two hemispheres [ 30 , 31 ] in the RAPID software which utilizes an automated AIF algorithm optimized for detection of candidate voxels and delay; it is corrected but uninformed about site occlusion [ 18 , 24 ].…”

“…Just a few works, with conflicting results, explore the accuracy of perfusion parameters according to different arterial input function (AIF) locations, such as when a stenosis is present before the intracranial occlusion, increasing the uncertainty in CTP accuracy in discriminating ischemic core [ 30 , 31 , 32 ].…”

Correlation between carotid stenosis and cognitive impairment

“…Many studies [8][9][10][11] have shown that angioplasty, stenting, endarterectomy, sta-mca bypass and other procedure can improve patients' cognitive function to varying degrees, suggesting that cognitive function may be related to brain attention. In other study [13], CT perfusion(CTP) imaging was performed on patients with carotid artery stenosis at different degrees, and the differences in cerebral perfusion results were analyzed in each group. The results showed that the perfusion parameters regional cerebral blood ow (regional cerebral blood ow(rCBF) regional cerebral blood volume (rCBV), mean transit time (MTT), time to peak (TTP) and delay time (DT) ) in the mild and moderate stenosis group had no statistical signi cance, only severe stenosis group showed decreased perfusion.…”