This technical note describes a novel CT scan protocol that includes a non-enhanced CT, dynamic CTA, and perfusion of the whole brain and CTA of the carotid arteries using a 320-row area detector CT scanner, with a unique contrast injection and acceptable radiation exposure dose in patients presenting with acute ischemic stroke. The acquisition parameters and reconstruction parameters will be discussed including the use of model-based iterative reconstruction (MBIR), time summing (tMIP), and subtraction techniques to optimize the results of this protocol.Key Points• Scanning on a 320-row area detector CT can achieve both brain perfusion with dynamic angiography and reconstructed arterial and venous CTA, and supra aortic trunk angiography, in a single acquisition. • It provides, in a single exam, a full diagnostic workup, i.e., all the acquisitions that are needed to make a quick decision, with reasonable exposure to ionizing radiation and reduced amount of medium contrast, in case of acute ischemic stroke presentation.
Keywords: Computed tomography angiography; Image reconstruction; Perfusion; Stroke.