Enter Your Email Address to Receive a
Copy of MedicExhange Member Demograhpics

Perfusion CT (PCT) plus CT angiography (CTA) appears to be as reliable as MRI in determining suitable candidates for reperfusion shortly after stroke symptom onset, according to study findings reported in the February 27th issue of Neurology.

"Relying on MRI or PCT/CTA to assess the site of arterial occlusion and the size of the infarct core and ischemic penumbra," lead investigator Dr. Max Wintermark told Reuters Health, "led to similar treatment decisions in a group of acute stroke patients."

Dr. Wintermark of the University of California, San Francisco and colleagues studied data on 42 patients who underwent both MRI and PCT/CTA within 3 to 9 hours of the appearance of stroke symptoms.

The team found ‘excellent’ correlation between methods in regard to infarct size, cortical involvement, and internal cerebral artery occlusion. There was 'substantial' correlation on the penumbra/infarct ratio.

Based on MRI finding, 14 patients would have been suitable candidates for reperfusion therapy. Relying on MRI or PCT/CTA, say the investigators, would have led to the same treatment decisions in all cases but one. This patient would have been treated based on MRI findings, but not on those from CT.

There were other instances of discordance, but these would not have affected the final decision. Dr. Wintermark added that "for the size criteria, a quantitative assessment of the PCT results may be more reliable than a subjective visual approach, especially for values close to the thresholds."

Neurology 2007;68:694-697.