• Hussam Shaker, Muhib Khan, Todd Mulderink, Tracy J Koehler, Raymond Scurek, Tricia Tubergen, Laurel Packard, Justin Singer, Paul Mazaris, Jiangyong Min, Nabil Wees, Nadeem Khan, and Tamer Abdelhak.
• Neuroscience Institute, Division of Neurology, Spectrum Health.
• J Neuroimaging. 2019 May 1; 29 (3): 331-334.

Background And PurposeInfarct core assessment on presentation is important to evaluate salvageable tissue to select patients for thrombectomy. Our study aims to evaluate the correlation between infarct core volume measured by computed tomography (CT) perfusion (CTP) and magnetic resonance diffusion-weighted imaging (MR-DWI) in patients with acute large-vessel occlusion.MethodsWe studied patients who underwent CTP on presentation to the emergency department for stroke symptoms. National Institute of Health Stroke Scale (NIHSS), collateral status, symptomatic vessels, and modified Rankin scale (mRS) at 90 days were collected. Admission infarct core volume was measured on initial relative cerebral blood volume and final infarct core volume on follow-up DWI. The correlation between two measures was assessed using Pearson's correlation coefficient.ResultsSeventy-four patients were studied of which 41.9% were female. Median NIHSS was 13 (2-30). Middle cerebral artery occlusion was present in 53 (71.6%) patients and 54 (72.9%) had good collaterals. Good functional outcome of mRS 0-2 was achieved by 60.8% at 90 days. There was a strong correlation between CTP and MR-DWI (r = .94). There was no significant difference between volume (in milliliters) on CTP (54.1 ± 69.8) and volume on DWI (50.3 ± 59.7; P = .18) using the paired t-test.ConclusionCTP provides a good estimation of the core infarct volume. It performs well within the clinically relevant thresholds for patient selection for thrombectomy.© 2019 by the American Society of Neuroimaging.

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