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Published online before print April 29, 2004, 10.1148/radiol.2313021488
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(Radiology 2004;231:632-644.)
© RSNA, 2004

Review

Cerebral Perfusion CT: Technique and Clinical Applications1

Ellen G. Hoeffner, MD, Ian Case, BS, RT(CT), Rajan Jain, MD, Sachin K. Gujar, MD, Gaurang V. Shah, MD, John P. Deveikis, MD, Ruth C. Carlos, MD, B. Gregory Thompson, MD, Mark R. Harrigan, MD and Suresh K. Mukherji, MD

1 From the Departments of Radiology (E.G.H., I.C., R.J., S.K.G., G.V.S., J.P.D., R.C.C., S.K.M.) and Neurosurgery (B.G.T., M.R.H.), University of Michigan Health System, 1500 E Medical Center Dr, University Hospital B2 A209, Ann Arbor, MI 48109. Received November 14, 2002; revision requested January 17, 2003; revision received March 21; accepted May 1. Address correspondence to E.G.H. (e-mail: hoeffner@umich.edu).

Perfusion computed tomography (CT) is a relatively new technique that allows rapid qualitative and quantitative evaluation of cerebral perfusion by generating maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). The technique is based on the central volume principle (CBF = CBV/MTT) and requires the use of commercially available software employing complex deconvolution algorithms to produce the perfusion maps. Some controversies exist regarding this technique, including which artery to use as input vessel, the accuracy of quantitative results, and the reproducibility of results. Despite these controversies, perfusion CT has been found to be useful for noninvasive diagnosis of cerebral ischemia and infarction and for evaluation of vasospasm after subarachnoid hemorrhage. Perfusion CT has also been used for assessment of cerebrovascular reserve by using acetazolamide challenge in patients with intracranial vascular stenoses who are potential candidates for bypass surgery or neuroendovascular treatment, for the evaluation of patients undergoing temporary balloon occlusion to assess collateral flow and cerebrovascular reserve, and for the assessment of microvascular permeability in patients with intracranial neoplasms. This article is a review of the technique, clinical applications, and controversies surrounding perfusion CT.

© RSNA, 2004

Index terms: Brain, CT, 13.12111, 13.12113, 13.12115 • Brain, infarction, 13.78 • Brain, ischemia, 13.721, 13.762, 13.767 • Brain, perfusion • Review




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