Comparison study of CT and positron emission tomographic data in recent cerebral infarction.

To better understand the pathophysiologic correlates of the computed tomographic (CT) scan changes seen in recent cerebral infarction, 17 patients (20 studies) underwent both x-ray transmission and positron emission CT investigations within 18 days after clinical onset of complicated ischemic stroke in the internal carotid artery territory. The density changes before and after contrast study measured within the CT lesion were correlated to the local cerebral blood flow (CBF), oxygen utilization (CMRO2), and oxygen extraction fraction (OEF) measured with the oxygen-15 steady-state positron technique. Statistically significant linear correlations were found between hypodensity and CBF, hypodensity and CMRO2, and contrast enhancement and CBF, such that the more CBF and CMRO2 were depressed, the more marked was the hypodensity; and the more CBF was elevated, the more marked was the contrast enhancement. Although marked contrast enhancement was associated with decreased OEF (luxury perfusion), it was only rarely associated with increased CBF. Various hypotheses are discussed to explain these findings.

[1]  T. H. Newton,et al.  Contrast enhancement of cerebral infarcts in computed tomography. , 1976, Radiology.

[2]  L. Jacobs,et al.  Computerized axial transverse tomography in cerebrovascular disease , 1976, Neurology.

[3]  W. H. Marshall,et al.  Recent ischemic brain infarcts at computed tomography: appearances pre- and postcontrast infusion. , 1975, Radiology.

[4]  B. Kendall,et al.  Contrast enhancement in ischaemic lesions , 1980, Neuroradiology.

[5]  M E Phelps,et al.  ECAT: a new computerized tomographic imaging system for positron-emitting radiopharmaceuticals. , 1978, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[6]  A A Lammertsma,et al.  A Theoretical Study of the Steady‐State Model for Measuring Regional Cerebral Blood Flow and Oxygen Utilisation Using Oxygen‐15 , 1981, Journal of computer assisted tomography.

[7]  N. Lassen,et al.  The luxury-perfusion syndrome and its possible relation to acute metabolic acidosis localised within the brain. , 1966, Lancet.

[8]  Y. Inoue,et al.  Sequential computed tomography scans in acute cerebral infarction. , 1980, Radiology.

[9]  R. Frackowiak,et al.  Quantitative Measurement of Regional Cerebral Blood Flow and Oxygen Metabolism in Man Using 15O and Positron Emission Tomography: Theory, Procedure, and Normal Values , 1980, Journal of computer assisted tomography.

[10]  R. Ackerman,et al.  Computed tomography of cerebral infarction: hemorrhagic, contrast enhancement, and time of appearance. , 1977, Computerized tomography.

[11]  J. Masdeu,et al.  Evaluation of recent cerebral infarction by computerized tomography. , 1977, Archives of neurology.

[12]  R. Ethier,et al.  The Computerized Tomographic Assessment of Brain Infarcts , 1981, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[13]  M. Ter-pogossian,et al.  The continuous inhalation of oxygen-15 for assessing regional oxygen extraction in the brain of man. , 1976, The British journal of radiology.

[14]  W. Heiss,et al.  Hyperperfusion and Enhancement in Dynamic Computed Tomography of Ischemic Stroke Patients , 1979, Journal of computer assisted tomography.

[15]  P. Kishore,et al.  CT contrast enhancement in cerebral infarction. , 1978, AJR. American journal of roentgenology.

[16]  D Comar,et al.  Reversal of Focal "Misery‐Perfusion Syndrome" By Extra‐Intracranial Arterial Bypass in Hemodynamic Cerebral Ischemia: A Case Study with 15O Positron Emission Tomography , 1981, Stroke.

[17]  E. Hoffman,et al.  Quantitation in Positron Emission Computed Tomography: 1. Effect of Object Size , 1979, Journal of computer assisted tomography.

[18]  M. Gado,et al.  The effect of size, histologic elements, and water content on the visualization of cerebral infarcts. , 1978, Archives of neurology.

[19]  L. Symon,et al.  Cerebral Blood Flow and Edema Following Carotid Occlusion in the Gerbil , 1980, Stroke.

[20]  L. Symon,et al.  Ischemic Brain Edema Following Middle Cerebral Artery Occlusion in Baboons: Relationship Between Regional Cerebral Water Content and Blood Flow at 1 to 2 Hours , 1979, Stroke.

[21]  Patterns of Brain Perfusion: Dynamic Computed Tomography Using Intravenous Contrast Enhancement , 1979, Journal of computer assisted tomography.

[22]  N. Alpert,et al.  Model for regional cerebral oxygen distrubition during continuous inhalation of /sup 15/O/sub 2/, C/sup 15/O, and C/sup 15/O/sub 2/ , 1978 .

[23]  M. Reivich,et al.  Error Analysis for the Determination of Cerebral Blood Flow with the Continuous Inhalation of 15O‐Labeled Carbon Dioxide and Positron Emission Tomography , 1982, Journal of computer assisted tomography.

[24]  A A Lammertsma,et al.  A Statistical Study of the Steady State Technique for Measuring Regional Cerebral Blood Flow and Oxygen Utilisation Using 15O , 1982, Journal of computer assisted tomography.

[25]  M. Bergström,et al.  Compartment Analysis of Contrast Enhancement in Brain Infarctions , 1979, Journal of computer assisted tomography.

[26]  J. Baron,et al.  Coupling between regional blood flow and oxygen utilization in the normal human brain. A study with positron tomography and oxygen 15. , 1983, Archives of neurology.

[27]  B. Kendall,et al.  Contrast enhancement in ischaemic lesions. I. Relationship to prognosis. , 1980, Neuroradiology.

[28]  J. Seylaz,et al.  [Quantitative measurement of cerebral blood flow]. , 1976, Annales de medecine interne.

[29]  R. Coleman,et al.  An extravascular component of contrast enhancement in cranial computed tomography. Part I. The tissue-blood ratio of contrast enhancement. , 1975, Radiology.

[30]  M. Meyer,et al.  Tissue Pertechnetate and Iodinated Contrast Material in Ischemic Stroke , 1980, Stroke.

[31]  H. Reulen,et al.  Increased tissue water in the brain: influence on regional cerebral blood flow and oxygen supply. , 1978, Advances in neurology.

[32]  D Comar,et al.  Noninvasive tomographic study of cerebral blood flow and oxygen metabolism in vivo. Potentials, limitations, and clinical applications in cerebral ischemic disorders. , 1981, European neurology.

[33]  J. Taveras,et al.  Cerebral infarction diagnosis by computerized tomography. Analysis and evaluation of findings. , 1975, The American journal of roentgenology, radium therapy, and nuclear medicine.

[34]  A. Tamura,et al.  Correlation Between rCBF and Histological Changes Following Temporary Middle Cerebral Artery Occlusion , 1980, Stroke.