CT perfusion with increased temporal sampling interval to predict target mismatch status in patients with acute ischemic stroke.

Purpose: To evaluate the feasibility of using CT perfusion (CTP) with increased temporal sampling interval to predict the target mismatch status in acute ischemic stroke (AIS) patients with anterior circular large-vessel occlusion (LVO).

Methods: CTP with a sampling interval of 1.7 s (CTP) was scanned in 77 AIS patients for pre-treatment evaluation. Simulated CTP data with sampling interval of 3.4 s (CTP) or 5.1 s (CTP) were reconstructed, respectively. Target mismatch was defined according to the EXTEND-IA (Extending the Time for Thrombolysis in Emergency Neurological Deficits-Intra-Arterial) and DEFUSE 3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke) trial criteria, respectively. Pearson correlation analysis, Mann-Whitney U test, Bland-Altman analysis, and chi-square test were used for statistical analysis as appropriate.

Results: Significant correlations were found on the volume of ischemic core, hypo-perfused area, mismatch area, and ratio between CTP and CTP or CTP (all p < 0.001). There was no significant difference on the volume of ischemic core, hypo-perfused area, mismatch area, and mismatch ratio between CTP and CTP or CTP (all p > 0.05). Compared with CTP, CTP or CTP showed comparable performance in predicting the target mismatch status in the AIS patients with LVO (both p > 0.05).

Conclusions: CTPs with increased temporal sampling intervals that lead to reduced radiation doses are feasible and may provide comparable performance in predicting target mismatch status in AIS patients with LVO.