CT CBV Perfusion Mapping As A Sign of Futility In Acute Ischemic Stroke
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Ischemic strokes constitute 80% of all strokes nationwide, but an imaging technique for predicting patient outcome is yet to be determined. This study effectively tests whether the Cerebral Blood Volume (CBV) imaging modality is a parameter of perfusion calculated from multiple CT images following contrast injection. 13,000 CT perfusion scans performed on identical scanners and paradigms from 2000 to 2010 were reviewed. A total of 451 showed measurable changes of perfusion/ischemia. CBV values were calculated and compared with final infarct size, calculated from CT (217) and MRI (234) scans performed 24+ hours after the initial infarct. Patient outcomes were divided into three categories based on hospital discharge: hospice/death, discharge to rehabilitation facility, or healthy discharge to home. Strokes represent a significant social and economic burden. Understanding the viability of tissue in acute ischemic strokes can allow physicians to better plan treatment paradigms and predict outcome. Time, effort, and money can be allocated more efficiently, as medical resources and procedures can be used on the patients who need them most.Our multi-site study shows that CBV can be used as an effective predictor of completed stroke (futility) and that the value of CBV is an excellent predictor of patient clinical outcome.