Comparative cranial CT enhancement in a primate model of cerebral infarction

The value of various enhancement techniques as opposed to nonenhanced CT scanning was compared in 15 baboons with cerebral infarction secondary to embolization of the left middle cerebral artery. The most prominent CT findings in infarction included an area of low absorption in the opercula–basal ganglia–centrum semiovale region and generalized lateral ventricular enlargement. Intravenous enhancement of the low-density region occurred in 25% of the animals and often obscured the preenhancement abnormality. However, a rapid bolus injection of contrast material followed by immediate consecutive CT scans (computed angiotomography) permitted prominent visualization of early-shunting veins. Delayed scanning following intrathecal enhancement better defined small infarctions that did not exhibit the usual cerebral blush. The CT imaging of inhaled xenon provides a new technique for evaluating subtle abnormalities in cerebral perfusion, even when the routine CT scan shows no abnormality.