Emergency Radiology

, Volume 26, Issue 5, pp 581–586 | Cite as

Misleading CT perfusion in subacute ischemic stroke

  • Houman SotoudehEmail author
  • Omid Shafaat
  • Ehsan Sotoudeh
Case Report


The RAPID© software is the most commonly used computed tomography perfusion (CTP) software in stroke centers. It is estimated that about 1300 hospitals in the world are using this software for decision-making in ischemic stroke. The software provides the estimated volume of infarction and ischemic penumbra, so it is the backbone of treatment planning in these patients. In this manuscript, we present two cases of subacute infarction with misleading CTP using RAPID© software. We believe that given the popularity of this software and increasing application of CTP in subacute infarction, this pitfall is likely underdiagnosed in many patients. In a subacute phase of infarction, we recommend diffusion-weighted imaging magnetic resonance imaging (DWI-MRI) for estimation of infarction to avoid this pitfall and possible mismanagement.


Computed tomography perfusion Ischemic stroke Software 


Author contributions

HS, OS, and ES contributed to the conception and design of the study. HS organized the database. HS, OS, and ES wrote the first draft of the manuscript. All authors contributed to manuscript revision and read and approved the submitted version.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© American Society of Emergency Radiology 2019

Authors and Affiliations

  1. 1.Department of Neuroradiology and NeurologyUniversity of Alabama at Birmingham (UAB)BirminghamUSA
  2. 2.Department of Radiology and Interventional NeuroradiologyIsfahan University of Medical SciencesIsfahanIran
  3. 3.Department of SurgeryIranian Hospital in DubaiDubaiUnited Arab Emirates

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