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Special Feature
March 2002

Radiological Case of the Month

Arch Pediatr Adolesc Med. 2002;156(3):294. doi:

Figure 1. Computed tomographic scan showing an extraventricular drain and cerebral edema. The anterior horn of the right lateral ventricle appears smaller than the left but is within normal limits. The xenon flow study shows the left hemisphere with normal perfusion and flow from 30 to 60 mL/100 mg of tissue per minute. The right frontal/parietal cortex is hypoperfused with flows of 20 mL/100 mg of tissue per minute, with sparing of the occipital region on posterior parietal lobes, where flows are 30 to 50 mL/100 mg of tissue per minute.

Stable xenon CT cerebral blood flow (CBF) determination is effective to evaluate brain perfusion after traumatic brain injury. Stable (nonradioactive) xenon gas is inhaled and acts as a tracer. The CT scan is obtained with specialized software, and the attenuation of the signal reflects the perfusion within the brain while the regional blood flow is quantitated. The scans are performed when arterial PCO2 and mean arterial blood pressure are known. Measurement of CBF coupled with information about ICP have been used to guide clinical management of traumatic brain injury. Xenon CT has been used in the evaluation of CBF in nontraumatic brain injury1 but its efficacy in guiding therapy is not as well established.

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