CT Perfusion
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0628-CT Perfusion
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CA0628-CT Perfusion
Case ReportExam
Prior Study
Negative study for acute arterial or venous occlusion.
There is a small completed lacunar infarct in the left caudate head.
The combination of a completed stroke and mild global atrophy and prominent basal ganglia calcificiation suggests the presence of underlying vasculopathy.
Findings
CT Perfusion
The time to peak (TTP) is very abnormal. There is fast flow (shortened TTP) in the left MCA, left PCA, and posterior fossa perfusion zones. There is shortened TTP in the centronuclear and thalamic perforator zones. There is prolonged TTP in the right MCA and ACA perfusion zones, in the left frontal area and over the left high convexity.
The included CTA demonstrates moyamoya vasculopathy worse on the right than left. This type of vasculopathy would account for the the CT perfusion pattern assuming the ICA stenosis is worse on the right than left and collateral arises from mainly the posterior fossa circulation into the P4-PCA arteries, but also from the less affected left ICA.
The cerebral blood volume (CBV) is only reduced in the left head of the caudate. CBV is increased in the right centronuclear and thalamic areas, and, in general, within most of the right cerebrum. CBV is within normal limits in the posterior fossa and left cerebrum.
Impression
2. Small completed infarct in the left caudate head.
Recommendations
No recommendation
