• Song Chaoyan, Zhang Qiang, Sun Qi, Zhang Hao, Shan Tonghui, Pan Wenlong, Wang Mei, Han Jingfeng, Deuerling-Zheng Yu, and Xu Ruxiang.
• Southern Medical University, Beijing, China; Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing, China.
• World Neurosurg. 2015 Dec 1;84(6):1629-35.

ObjectivesCerebral blood volume (CBV) acquired with the use of flat-detector computed tomography with contrast media (CM) injected at the ascending aorta provides real-time brain functional information with minimized CM usage; however, unexpected asymmetric perfusion is observed for certain patients without cerebral circulatory disorders. This work tested the feasibility of left ventricle (LV) CM injection to achieve symmetric perfusion.MethodsCBV maps were acquired for 10 patients without perfusion-related cerebral abnormities. Perfusion symmetry was predicted with the use of color-coded quantitative digital subtracted angiography with CM injected at ascending aorta. Time density curves were extracted at bilateral common carotid arteries with area under curves calculated. Planes were selected on CBV maps with regions of interest defined covering characteristic regions, where asymmetric perfusion most likely to appear.ResultsNo adverse physiological changes were detected for any patient. Non-uniform CM distributions were detected for 4 patients with relative area under curves 0.66 ± 0.03, indicating asymmetric perfusion using ascending aorta injection. With LV injection, all the patients demonstrated good perfusion symmetry with relative CBV 1.03 ± 0.07.ConclusionCBV maps acquisition with LV injection offered an approach to acquire immediate brain functional information for patients who are limited by asymmetric perfusion using ascending aorta injection and are sensitive to CM dose.Copyright © 2015 Elsevier Inc. All rights reserved.

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