To know the features and indications of CT cerebral perfusion (CTp). Describe the advantages and disadvantages of CTp, and the radiation dose reduction strategies. Review illustrative clinical cases, analyzing the CTp parameters according to a proposed guideline.

The CTp is a 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)(Fig. 1, Fig. 2). There are some complementary parameters such as the permeability map of the blood-brain barrier (Fig. 3). Perfusion studies are obtained by monitoring the first pass of an iodinated contrast agent bolus through the cerebral vasculature. There is a linear relationship...

We present different clinical entities that have been studied in our institution with CTp, where itprovidedrelevant information to diagnosis and treatment. Based on the parameters of cerebral perfusion (Fig. 5), we propose a table for the interpretation of the different maps and their quantitative values, withthe normal and abnormal limits that determine hypo - hyperperfusion, ischemia, penumbra and core infarction(Fig. 6). Crossed cerebellar diaschisis Crossed cerebellar diaschisis is a depression in neuronal metabolism and activity characterized by decreased brain perfusion in the cerebellar hemisphere contralateral...

CTp is a useful and widely available technique to asses brain perfusion. Its main disadvantage is radiation exposure, which can be reduced by adjusting the acquisition parameters. Themain application of CTp is the evaluation of stroke patients, but indications are quickly expanding to include assessment of others clinical scenarios such asglobal and focal hypo - hyperperfusion states,cerebral revascularization studies, estimation of tumour gradein gliomas and post-convulsive hemodynamic changes. We presented an interpretation tablethat we believe will make the analysis of the different maps and their...

Luis Canales Franco MD [email protected] Department of Radiology, Universidad de Chile

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