Evaluation of Patients with Acute Ischemic Stroke Using Angiographic C-arm Cerebral Blood Volume (C-arm CBV) Measurements

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Objective: CT-like images and cerebral blood volume (CBV) measurements have become available due to technical improvements in the angiographic C-arm system and workstation. In this study, we evaluated the usefulness of C-arm CBV measurements in patients with acute ischemic stroke.

Methods: The study included 27 consecutive patients admitted for acute ischemic stroke due to major intracranial artery occlusion within 7 hours of onset. Cerebral angiography and C-arm CBV measurements were performed immediately after CT or MRI. The areas with reduced CBV in CBV color maps were classified into infarcted and non-infarcted areas according to CT/MRI images obtained 8–48 hours after onset, and their relationship with CBV was retrospectively evaluated.

Results: The mean CBV values and the relative CBV ratios (ipsilateral/contralateral side) were 1.29 ± 0.51 mL/100 g and 0.41 ± 0.17 in the infarcted area and 3.19 ± 0.17 mL/100 g and 0.8 ± 0.1 in the non-infarcted areas. The CBV values and relative CBV ratios in infarcted areas with hemorrhage (n = 5) were 0.95 ± 0.56 mL/100 g and 0.3 ± 0.17, and significantly lower than in infarcted areas without hemorrhage.

Conclusion: C-arm CBV measurements with an angiography system can be performed readily in a short time and may provide useful information for the treatment of acute ischemic stroke patients.