Computed tomography perfusion of the brain (CT perfusion)

This article is professionally consulted by Master, Doctor Vu Huy Hoang - Radiologist - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International Hospital.

CT perfusion or cerebral perfusion computed tomography is a modern imaging method. Applied in the assessment of cerebral perfusion level when there is a suspicion of perfusion abnormalities. This method is especially valuable in fulminant ischemic stroke to identify the penumbra (the twilight zone, this is an area that can be saved if appropriate treatment measures are applied.
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Brain perfusion computed tomography is an imaging method that uses multiple X-rays to scan the brain pool in cross-section, combined with computer technical processing to produce 2D or 3D images of the brain. After taking the image, the doctor will diagnose and examine the perfusion capacity of the brain parenchyma.
The information obtained will be used to assess the extent of brain parenchymal damage in stroke, to determine which brain tissue can be saved. In addition, CT perfusion is also used to evaluate vascular abnormalities in certain pathologies such as stenosis, dilation, and aneurysm of intracranial and extracranial blood vessels.
The person performing the method must be an imaging specialist, an electro-optical technician who is well versed in CT scanning operations. The type of machine used is usually 512-slice multi-slice computed tomography (8 rows or more).
Other medical supplies used to perform the procedure include:
10ml and 20ml syringes. Injection pump for specialized electric pumps. Injection type 18-20G. Contrast is soluble in water. Antiseptic solution for skin and mucous membranes. Physiological saline or distilled water. Gloves, masks, hats, cotton, sterile gauze. Surgical forceps, bean tray. First aid box in case the patient has an accident when using contrast agents.

Stroke : Acute and fulminant phase of cerebral infarction. Assess the degree of vascular proliferation of brain tumors. Cerebral stenosis is suspected to affect cerebral perfusion. Monitor the patient's condition after fibrinolytic therapy or arterial thrombectomy.

The method is contraindicated in people who are allergic to contrast agents. Relative contraindications for pregnant women and the presence of metal in the craniofacial region affecting image quality.

The patient is explained about the technique to cooperate with the doctor during the scan. Before performing, you should remove metal objects such as earrings, necklaces, hairpins to avoid disturbing the image. Before taking the picture, you need to fast for 4 hours, the amount of water you need to drink must not exceed 50ml.
If the patient cannot lie still, sedation can be used with an appropriate dose.
The patient is placed supine on the imaging table to perform computed tomography brain perfusion.

Positioning The cranial imaging field is set according to a procedure for the upper examination area, the thickness of the cut layer under the tent is about 2 to 3mm, and the layer above the tent is about 7 to 8mm. Preliminary assessment of damage. Assess the need and value needed to perform cerebral perfusion imaging. Using an 18G needle to place a vein, connecting to a dedicated electric pump with 2 drugs to control the injection speed (1 barrel is physiological salt, the other barrel is medicine) Place the layer at the lesion to be assessed. cerebral perfusion rates. Shoot according to the default mode that the computer has pre-installed. After taking, image processing on the working screen, measuring parameters such as blood flow, blood volume, average weight transfer time, peak time of the examination area. The doctor will read the lesions, describe them on the computer and print the results to return to the patient.

The image must clearly show the twilight of the brain parenchyma. Shows large vascular structures at the base of the patient's skull.

Patients after computed tomography brain perfusion with contrast injection were kept in the room for observation for a period of 30 minutes. If there is no abnormality, the medical staff will remove the needle if there is no indication to use intravenous infusion.
After the needle is removed, the patient should press on the injection site for about 5 to 10 minutes to prevent bleeding.
After leaving, the patient needs to actively drink a lot of water within 24 hours to eliminate the contrast agent out of the body.

In case the patient is too excited or scared, the doctor needs to do mental work to stabilize the patient's psyche. Contrast-contrast events: Follow the procedure for diagnosing and handling contrast-enhancement accidents that have been issued by the Ministry of Health. After returning home, if you have any unusual symptoms such as headache, dizziness, nausea, fever, shortness of breath, etc., you must immediately go to a medical facility for timely examination.

Computed tomography (CT) perfusion of the brain is one of the imaging techniques applied by Vinmec International General Hospital to detect brain diseases, cerebrovascular malformations, etc. ..early diagnosis of cerebral stroke at an early stage,...Especially in order to improve diagnostic results, Vinmec has been and continues to invest in modern CT, X-ray, and MRI machines. ... combined with medical services of examination, treatment and early screening of cancers. With a team of highly qualified and experienced medical doctors, direct consultation, examination and treatment will bring optimal treatment results to customers.
Doctor Vu Huy Hoang has 10 years of experience working in the field of diagnostic imaging, formerly a Doctor at the Department of Diagnostic Imaging - Thai Nguyen Central Hospital. Currently, the doctor is working at the Department of Diagnostic Imaging - Vinmec Times City International Hospital.
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