Comparison of Diagnostic Usefulness of Multi-Channel CT Perfusion and Conventional Brain CT in the Acute Pontine Infarct

CT perfusion (CTP) is an important modality in the diagnosis of acute stroke, and the range of its use is gradually expanding from supratentorial to whole brain stroke. We assessed the diagnostic value of multichannel CTP in comparison with conventional CT (CT) in acute pontine infarct. CTP and follow-up diffusion weighted magnetic resonance imaging were performed in 74 patients diagnosed with acute pontine infarct among 178 suspicious ones. Diagnostic accuracy of CTP and CT was evaluated and quantitative analysis was performed to define the factors that may influence the detection rate. In the diagnosis of acute pontine infarct, the sensitivity, specificity, and accuracy of CTP was 56.8%, 91.4%, and 77.0% and of conventional CT scan was 47.3%, 93.3%, and 74.2%, respectively. There was no statistically significant difference. Receiver operation characteristic curve revealed both types of imaging to have diagnostic usefulness (p < 0.01) in acute pontine infarct. Among the factors that may affect the detection rate, infarct volume was found to be statistically significant (CTP: p < 0.01, CT: p = 0.01). This is the first study that analyzed the difference between CTP and CT in the diagnostic accuracy of acute pontine infarction. Both CTP and CT are useful diagnostic tools although CTP seems to have a slightly higher detection rate than CT.