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An 88-year-old woman with a medical history of diabetes, hypertension, and atrial fibrillation presented to the emergency room after being found unresponsive with a NIH Stroke Scale score of 23 and Glasgow Coma Scale score of 3. She was unresponsive to painful stimuli. Noncontrast CT demonstrated bilateral thalamic infarcts (figure 1A).

A 50-year-old woman presented with 4 weeks of ascending paralysis associated with nausea, vomiting, hypophonia, and dyspnea. Examination revealed hypophonia, diminished strength in the upper and lower extremities, increased reflexes throughout, and a T10 sensory level. Imaging ([figures 1][1] and [2

Objective: MTT map is a sensitive and specific map differentiating ischemic penumbra (IP) from infarct core (IC) in acute stroke. Background We present eight patients with acute ischemic stroke who presented to our emergency department and underwent computed tomography perfusion (CTP) imaging utilizing the Toshiba Aquilion ONE 320-dectector row CT scanner running a Singular Value Decomposition Plus (SVD+) algorithm to generate perfusion maps. Design/Methods: A retrospective analysis of patients who presented with an acute ischemic stroke was performed. Patients receiving a high quality whole-brain CTP scan without evidence of hemorrhage on initial or follow-up CT who additionally underwent follow up MRI with DWI within 48 hours were included. Vitrea FX 3.1 software was utilized by a single, blinded neuroradiologist to process images. At risk territory was defined by the area of delayed perfusion on the time to peak map. The IC volume on the MTT map, as determined by values less than 3 seconds within this at risk territory, was measured on each slice. The total IC volumes were calculated by taking the sum of the IC on individual slices multiplied by the thickness of each slice. Pearson correlation was applied to assess for statistical correlation between IC on CTP and area of restriction on follow up DWI. Results: A comparison was made between the volumes of infarct core utilizing SVD+ MTT maps and DWI MR sequences. There was a significant correlation between infarct core volumes measured on MTT and infarct volumes on follow up DWI (r = 0.79). Conclusions: Although further studies are required to validate this observation, preliminary studies suggest that utilization of the SVD+ MTT map may allow for an accurate assessment of the infarct core and surrounding salvageable tissue. The additional information garnered from accurate interpretation of the SVD+ MTT maps may further guide clinicians in critical decision making during acute ischemic events. Disclosure: Dr. Dababneh has nothing to disclose. Dr. Guerrero has nothing to disclose. Dr. Wilson has nothing to disclose. Dr. Mocco has received personal compensation for activities with Concentric Inc as a consultant. Dr. Bennett has nothing to disclose. Dr. Hoh has received personal compensation for activities with Codman Neurovascular. Dr. Yuzeforich-Khanna has nothing to disclose. Dr. Peters has received personal compensation for activities with Toshiba as a speaker. Dr. Waters has nothing to disclose.