Perfusion-CT for early assessment of traumatic cerebral contusions

Soustiel, Jean F.; Mahamid, Eugenia; Goldsher, Dorith; Zaaroor, Menashe

doi:10.1007/s00234-007-0337-7

Cited by 53 publications

(34 citation statements)

References 30 publications

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“…However, there is a radiation penalty to be paid for this frequent scanning as well as a (albeit low) morbidity/mortality rate associated with the administration of iodinated contrast media. A few recent studies have assessed regional cerebral hemodynamics using perfusion CT in relation to clinical variables such as post-traumatic amnesia in patients with mild brain injury (Metting et al, 2010), and assessment, monitoring, and prognostication in patients with more severe injury (Soustiel et al, 2008;Wintermark et al, 2004a,b).…”

Section: Perfusion Imagingmentioning

confidence: 99%

Emerging Imaging Tools for Use with Traumatic Brain Injury Research

Hunter

Wilde

Tong

et al. 2012

Journal of Neurotrauma

113

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This article identifies emerging neuroimaging measures considered by the inter-agency Pediatric Traumatic Brain Injury (TBI) Neuroimaging Workgroup. This article attempts to address some of the potential uses of more advanced forms of imaging in TBI as well as highlight some of the current considerations and unresolved challenges of using them. We summarize emerging elements likely to gain more widespread use in the coming years, because of 1) their utility in diagnosis, prognosis, and understanding the natural course of degeneration or recovery following TBI, and potential for evaluating treatment strategies; 2) the ability of many centers to acquire these data with scanners and equipment that are readily available in existing clinical and research settings; and 3) advances in software that provide more automated, readily available, and cost-effective analysis methods for large scale data image analysis. These include multi-slice CT, volumetric MRI analysis, susceptibility-weighted imaging (SWI), diffusion tensor imaging (DTI), magnetization transfer imaging (MTI), arterial spin tag labeling (ASL), functional MRI (fMRI), including resting state and connectivity MRI, MR spectroscopy (MRS), and hyperpolarization scanning. However, we also include brief introductions to other specialized forms of advanced imaging that currently do require specialized equipment, for example, single photon emission computed tomography (SPECT), positron emission tomography (PET), encephalography (EEG), and magnetoencephalography (MEG)/magnetic source imaging (MSI). Finally, we identify some of the challenges that users of the emerging imaging CDEs may wish to consider, including quality control, performing multi-site and longitudinal imaging studies, and MR scanning in infants and children.

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Section: Perfusion Imagingmentioning

confidence: 99%

Emerging Imaging Tools for Use with Traumatic Brain Injury Research

Hunter

Wilde

Tong

et al. 2012

Journal of Neurotrauma

113

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show abstract

“…The exact methodology used to calculate quantitative perfusion maps varies greatly, and absolute quantification is problematic at this time. More recently, CTP has been used in TBI studies (63,64), but there are few papers using perfusion-weighted MRI (65). MRI arterial spin labeling is finding its place as an alternate approach to image perfusion without the use of a contrast agent (66)(67)(68)(69).…”

Section: Conventional Mri Techniquesmentioning

confidence: 99%

“…Both focal and diffuse perfusion abnormalities have been reported (63). Focal perfusion abnormalities are typically observed in and around contusions, even before they become apparent on structural imaging (63)(64)(65). Perfusion, measured using Xenon-enhanced computed tomography (Xe-CT) (80)(81)(82)(83), CTP (63), and DSC-MRI (82)(83)(84), are altered in peri-contusional edematous regions, suggesting ongoing ischemic damage, and a role for perfusion imaging in prognosis (63,85).…”

Section: Conventional Mri Techniquesmentioning

confidence: 99%

Common data elements in radiologic imaging of traumatic brain injury

Haacke,

Duhaime,

Gean

et al. 2010

Magnetic Resonance Imaging

159

164

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Traumatic brain injury (TBI) has a poorly understood pathology. Patients suffer from a variety of physical and cognitive effects that worsen as the type of trauma worsens. Some noninvasive insights into the pathophysiology of TBI are possible using magnetic resonance imaging (MRI), computed tomography (CT), and many other forms of imaging as well. A recent workshop was convened to evaluate the common data elements (CDEs) that cut across the imaging field and given the charge to review the contributions of the various imaging modalities to TBI and to prepare an overview of the various clinical manifestations of TBI and their interpretation. Technical details regarding state-of-the-art protocols for both MRI and CT are also presented with the hope of guiding current and future research efforts as to what is possible in the field. Stress was also placed on the potential to create a database of CDEs as a means to best record information from a given patient from the reading of the images.

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“…Soustiel et al 79 studied 30 patients with cerebral contusions using PCT and found that admission CBV and CBF maps were highly compatible with the findings of follow-up noncontrast CT scans around 2 weeks after injury. Perfusion CT performed in the acute phase of mild TBI has been shown to detect perfusion abnormalities in patients with normal noncontrast CT scans.…”

Section: Patients With Mild Tbi and Postconcussion Syndromementioning

confidence: 84%

Clinical application of perfusion computed tomography in neurosurgery

Huang

Tsai

Kuo

et al. 2014

JNS

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Object Currently, perfusion CT (PCT) is a valuable imaging technique that has been successfully applied to the clinical management of patients with ischemic stroke and aneurysmal subarachnoid hemorrhage (SAH). However, recent literature and the authors' experience have shown that PCT has many more important clinical applications in a variety of neurosurgical conditions. Therefore, the authors share their experiences of its application in various diseases of the cerebrovascular, neurotraumatology, and neurooncology fields and review the pertinent literature regarding expanding PCT applications for neurosurgical conditions, including pitfalls and future developments. Methods A pertinent literature search was conducted of English-language articles describing original research, case series, and case reports from 1990 to 2011 involving PCT and with relevance and applicability to neurosurgical disorders. Results In the cerebrovascular field, PCT is already in use as a diagnostic tool for patients suspected of having an ischemic stroke. Perfusion CT can be used to identify and define the extent of the infarct core and ischemic penumbra core, and thus aid patient selection for acute reperfusion therapy. For patients with aneurysmal SAH, PCT provides assessment of early brain injury, cerebral ischemia, and infarction, in addition to vasospasm. It may also be used to aid case selection for aggressive treatment of patients with poor SAH grade. In terms of oncological applications, PCT can be used as an imaging biomarker to assess angiogenesis and response to antiangiogenetic treatments, differentiate between glioma grades, and distinguish recurrent tumor from radiation necrosis. In the setting of traumatic brain injury, PCT can detect and delineate contusions at an early stage. In patients with mild head injury, PCT results have been shown to correlate with the severity and duration of postconcussion syndrome. In patients with moderate or severe head injury, PCT results have been shown to correlate with patients' functional outcome. Conclusions Perfusion CT provides quantitative and qualitative data that can add diagnostic and prognostic value in a number of neurosurgical disorders, and also help with clinical decision making. With emerging new technical developments in PCT, such as characterization of blood-brain barrier permeability and whole-brain PCT, this technique is expected to provide more and more insight into the pathophysiology of many neurosurgical conditions.

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Perfusion-CT for early assessment of traumatic cerebral contusions

Abstract: PCT confirmed the results of xenon-CT studies and was shown to allow better evaluation of tissue viability than noncontrast CT. These findings suggest that PCT could be implemented in the future for the early assessment of patients with traumatic brain injury.

Cited by 53 publications

References 30 publications

Emerging Imaging Tools for Use with Traumatic Brain Injury Research

Emerging Imaging Tools for Use with Traumatic Brain Injury Research

Common data elements in radiologic imaging of traumatic brain injury

Clinical application of perfusion computed tomography in neurosurgery

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