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Clot Burden and Collaterals in Anterior Circulation Stroke: Differences Between Single-Phase CTA and Multi-phase 4D-CTA.
Kaschka, I N; Kloska, S P; Struffert, T; Engelhorn, T; Gölitz, P; Kurka, N; Köhrmann, M; Schwab, S; Doerfler, A.
Afiliación
  • Kaschka IN; Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany. iris.kaschka@uk-erlangen.de.
  • Kloska SP; Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
  • Struffert T; Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
  • Engelhorn T; Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
  • Gölitz P; Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
  • Kurka N; Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
  • Köhrmann M; Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
  • Schwab S; Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
  • Doerfler A; Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
Clin Neuroradiol ; 26(3): 309-15, 2016 Sep.
Article en En | MEDLINE | ID: mdl-25410583
PURPOSE: It has been reported that the extent of intravascular thrombi and the quality of collateral filling in computed tomography (CT) angiography are predictive for the clinical outcome in patients with acute stroke. We hypothesized that multi-phase four-dimensional CTA (4D-CTA) allows better assessment of clot burden and collateral flow compared with arterial single-phase CTA (CTA). METHODS: In 49 patients (33 female; age: 77 ± 12 years) with acute anterior circulation stroke, CTA and 4D-CTA reconstructed from dynamic perfusion CT data were analyzed for absolute thrombus length (TL), clot burden score (CBS), and collateral score (CS). The length of the filling defect was also defined on thin-slice nonenhanced CT as corresponding hyperdense middle cerebral artery sign (HMCAS) when present. RESULTS: There was good correlation (r = 0.62, p < 0.01) between the length of HMCAS (1.29 ± 0.62 cm) and TL in 4D-CTA (1.22 ± 0.51 cm). 4D-CTA and CTA significantly varied (p < 0.01) in TL (1.42 ± 0.73 cm (CTA) versus 1.11 ± 0.62 cm (4D-CTA)), CBS (median: 5, interquartile range: 4-7 (CTA) versus median: 6, interquartile range: 5-8 (4D-CTA); p < 0.001), and CS (median: 2, interquartile range: 1-2 (CTA) versus median: 3, interquartile range: 2-3 (4D-CTA); p < 0.001). Accordingly, CTA significantly overrated clot burden and underestimated collateral flow. CONCLUSIONS: 4D-CTA more closely defines clot burden and collateral supply in anterior circulation stroke than CTA, implicating an additional diagnostic benefit.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Angiografía Cerebral / Intensificación de Imagen Radiográfica / Infarto Encefálico / Trombosis Intracraneal / Tomografía Computarizada Cuatridimensional / Angiografía por Tomografía Computarizada Tipo de estudio: Diagnostic_studies / Etiology_studies / Evaluation_studies / Prognostic_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Clin Neuroradiol Asunto de la revista: NEUROLOGIA / RADIOLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Angiografía Cerebral / Intensificación de Imagen Radiográfica / Infarto Encefálico / Trombosis Intracraneal / Tomografía Computarizada Cuatridimensional / Angiografía por Tomografía Computarizada Tipo de estudio: Diagnostic_studies / Etiology_studies / Evaluation_studies / Prognostic_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Clin Neuroradiol Asunto de la revista: NEUROLOGIA / RADIOLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania