CT Angio Head with Perfusion, CT Angio Neck- 10/2/24
EXAM: CT ANGIO HEAD W PERFUSION, CT ANGIO NECK
CLINICAL HISTORY FROM EPIC: WEAKNESS
COMPARISON: None
TECHNIQUE: CT angiogram of the neck and Circle of Willis with perfusion imaging
was performed using 125 cc Isovue 370. Multiplanar reconstruction were
performed. 3-D images were generated at a dedicated workstation and reviewed by
the radiologist.
RADIATION DOSE: Total DLP = 2708.32 mGy*cm. An iterative reconstruction
technique was used to reduce radiation dose.
FINDINGS:
CT NECK: Incidentally noted two-vessel arch. No significant stenosis at the
origin of the great vessels. Vertebral arteries are patent throughout. No
evidence of dissection. No significant atherosclerosis of the common carotid
arteries. Mild mixed plaque within the left carotid bulb. No significant ICA
stenosis bilaterally.
CTA HEAD: There is fetal origin of the left PCA. Moderate atherosclerosis of
the carotid siphons. Normal MCA trifurcation bilaterally. Anterior communicating
artery is patent. No evidence of aneurysm, occlusion or significant stenosis.
CT PERFUSION:
TECHNICAL: The AIF and VOF curves demonstrate good bolus with curves
demonstrating sharp upstroke, no truncation and no jagged lines to suggest
motion.
TOTAL HYPOPERFUSION: Using the threshold of Tmax greater than 6 seconds, the
total volume of hypoperfusion of Tmax greater than 6 seconds volume 61 mL.
CORE INFARCT: Using a CBF less than 30%, the total volume of ischemic core of
CBF <30% volume 0.0 mL.
PENUMBRA: The penumbra volume (mismatch volume) is mismatch volume 0.0 mL. The
mismatch ratio is : infinite.
​
IMPRESSION:
1. The perfusion study shows a total volume of ischemia in the right MCA
territory of 61 cc using a threshold of Tmax greater than 6 seconds, but there
is no vascular stenosis or occlusion identified.
2. No aneurysm or vascular malformation identified.
3. Unremarkable CTA of the neck.
Results were called to the ED on 10/2/2024 5:10 PM.
Signed by Bellatrix Fudge, MD on 10/2/2024 at 5:10 PM