Stroke is a leading cause of disability and death. Effective treatment decisions require early and informative vascular imaging. 4D perfusion imaging is ideal but rarely available within the first hour after stroke, whereas plain CT and CTA usually are. Hence, we propose a framework to extract a predicted perfusion map (PPM) derived from CT and CTA images. In all eighteen patients, we found significantly high spatial similarity (with average Spearman's correlation = 0.7893) between our predicted perfusion map (PPM) and the T-max map derived from 4D-CTP. Voxelwise correlations between the PPM and National Institutes of Health Stroke Scale (NIHSS) subscores for L/R hand motor, gaze, and language on a large cohort of 2,110 subjects reliably mapped symptoms to expected infarct locations. Therefore our PPM could serve as an alternative for 4D perfusion imaging, if the latter is unavailable, to investigate blood perfusion in the first hours after hospital admission.

翻译：脑卒中是导致残疾和死亡的主要原因。有效的治疗决策需要早期且信息丰富的血管影像学检查。四维灌注成像虽为理想选择，但在卒中后第一小时内通常难以获得，而平扫CT和CTA检查则更易实现。因此，我们提出一种从CT和CTA图像中提取预测灌注图谱（PPM）的框架。在全部18例患者中，我们发现预测灌注图谱（PPM）与基于四维CTP获得的T-max图之间存在显著的高空间相似性（平均斯皮尔曼相关系数=0.7893）。在包含2110例受试者的大规模队列中，PPM与美国国立卫生研究院卒中量表（NIHSS）中左/右手运动、凝视及语言亚项评分的体素级相关性，可可靠地将症状映射至预期的梗死区域。因此，若四维灌注成像不可用时，我们的PPM可作为替代方案，用于评估入院后最初数小时内的脑血流灌注情况。