Whole brain CT perfusion deficits using 320-detector-row CT scanner in TIA patients are associated with ABCD2 score

Document Type

Article

Abstract

BACKGROUND: Transient ischemic attacks (TIA) are cerebral ischemic events without infarction. The uses of CT perfusion (CTP) techniques such as cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT) and cerebral blood flow (CBF) provide real time data about ischemia. It has been shown that CTP changes occur in less sensitive CTP scanners in patients with TIA. Larger detector row CTP (whole brain perfusion studies) may show that CTP abnormalities are more prevalent than previously noted. It is also unclear if these changes are associated with TIA severity. OBJECTIVE: To demonstrate that TIA patients are associated with perfusion deficits using whole brain 320-detector-row CT perfusion, and to determine an association between ABCD2 score and perfusion deficit using whole brain perfusion. METHODS: We retrospectively reviewed all TIA patients for CTP deficits from 2008-2010. Perfusion imaging was reviewed at admission; and it was determined if a perfusion deficit was present along with vascular territory involved. RESULTS: Of 364 TIA patients, 62 patients had CTP deficits. The largest group of patients had MCA territory involved with 48 of 62 patients (77.42%). The most common perfusion abnormality was increased TTP with 46 patients (74.19%). The ABCD2 score was reviewed in association with perfusion deficit. Increased age >60, severe hypertension (>180/100 mmHg), patients with speech abnormalities, and duration of symptoms >10 min were associated with a perfusion deficit but history of diabetes or minimal/moderate hypertension (140/90-179/99 mmHg) was not. There was no association between motor deficit and perfusion abnormality. CONCLUSION: Perfusion deficits are found in TIA patients using whole brain CTP and associated with components of the ABCD2 score.

Medical Subject Headings

Adult; Aged; Aged, 80 and over; Brain (blood supply, pathology); Cerebrovascular Circulation (physiology); Female; Humans; Imaging, Three-Dimensional; Ischemic Attack, Transient (diagnostic imaging, pathology); Male; Middle Aged; Perfusion Imaging; Predictive Value of Tests; Severity of Illness Index; Tomography, X-Ray Computed

Publication Date

1-1-2014

Publication Title

The International journal of neuroscience

E-ISSN

1563-5279

Volume

124

Issue

1

First Page

56

Last Page

60

PubMed ID

23826759

Digital Object Identifier (DOI)

10.3109/00207454.2013.821471

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