scholarly journals Multiphase CT Angiography: A New Tool for the Imaging Triage of Patients with Acute Ischemic Stroke

Radiology ◽  
2015 ◽  
Vol 275 (2) ◽  
pp. 510-520 ◽  
Author(s):  
Bijoy K. Menon ◽  
Christopher D. d’Esterre ◽  
Emmad M. Qazi ◽  
Mohammed Almekhlafi ◽  
Leszek Hahn ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ct Angiography ◽  
Multiphase Ct

scholarly journals Validation of collateral scoring on flat-detector multiphase CT angiography in patients with acute ischemic stroke

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0202592 ◽  
Author(s):  
Ilko L. Maier ◽  
Fabien Scalzo ◽  
Johanna R. Leyhe ◽  
Katharina Schregel ◽  
Daniel Behme ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ct Angiography ◽  
Flat Detector ◽  
Multiphase Ct

scholarly journals Automated Prediction of Ischemic Brain Tissue Fate from Multi-Phase CT-Angiography in Patients with Acute Ischemic Stroke Using Machine Learning

2020 ◽  
Author(s):  
Wu Qiu ◽  
Hulin Kuang ◽  
Johanna Ospel ◽  
Michael D Hill ◽  
Andrew Demchuk ◽  
...  
Keyword(s):  
Machine Learning ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Correlation Coefficient ◽  
Ct Angiography ◽  
Tissue Perfusion ◽  
Dice Similarity Coefficient ◽  
Derivation Cohort ◽  
Multiphase Ct

Background: Multiphase CT-Angiography (mCTA) provides time variant images of the pial vasculature supplying brain in patients with acute ischemic stroke (AIS). To develop a machine learning (ML) technique to predict infarct, penumbra and tissue perfusion from mCTA source images. Methods: 284 patients with AIS were included from the PRoveIT study. All patients had non-contrast CT, mCTA and CTP imaging at baseline and follow up MRI/NCCT imaging. Of the 284 patient images, 140 patient images were randomly selected to train and validate three ML models to predict infarct, penumbra, and perfusion parameter on CTP, respectively. The remaining unseen 144 patient images independent of the derivation cohort were used to test the derived ML models. The predicted infarct, penumbra, and perfusion volume from ML models was spatially and volumetrically compared to manually contoured follow up infarct and time-dependent Tmax thresholded volume (CTP volume), using Bland-Altman plots, concordance correlation coefficient (CCC), intra-class correlation coefficient (ICC), and Dice similarity coefficient (DSC). Results: Within the test cohort, Bland-Altman plots showed that the mean difference between the mCTA predicted infarct and follow up infarct was 21.7 mL (limit of agreement (LoA): -41.0 to 84.3mL) in the 100 patients who had acute reperfusion (mTICI 2b/2c/3), and 3.4mL (LoA: -66 to 72.9mL) in the 44 patients who did not achieve reperfusion (mTICI 0/1). Amongst reperfused subjects, CCC was 0.4 [95%CI: 0.15-0.55, P<.01] and ICC 0.42 [95% CI: 0.18-0.50, P<.01]; in non-reperfused subjects CCC was 0.52 [95%CI: 0.2-0.6, P<.001] and ICC 0.6 [95% CI: 0.37-0.76, P<.001]. No difference was observed between the mCTA and CTP predicted infarct volume for the overall test cohort (P=.67). Conclusion: Multiphase CT Angiography is able to predict infarct, penumbra and tissue perfusion, comparable to CT perfusion imaging.

Asymmetry of medullary veins on multiphase CT-angiography in patients with acute ischemic stroke

2020 ◽  
Vol 29 (10) ◽  
pp. 105064
Author(s):  
A.A. Drozdov ◽  
R. Javan ◽  
C.R. Leon Guerrero ◽  
A.D. Sparks ◽  
M.R. Taheri
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ct Angiography ◽  
Multiphase Ct

Abstract W P37: Accuracy Of CT Angiography In The Localization Of Carotid Occlusion Sites In Acute Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Marcelo Rocha ◽  
William T Delfyett ◽  
Amin Aghaebrahim ◽  
Ashutosh Jadhav ◽  
Tudor Jovin
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ct Angiography ◽  
Target Lesion ◽  
Carotid Occlusion ◽  
Conventional Angiography ◽  
Vessel Occlusion ◽  
Cerebral Vessel ◽  
Ct Angiogram ◽  
Comprehensive Stroke Center

Background and Purpose: CT angiography yields rapid detection of a major cerebral vessel occlusion during the evaluation of patients with acute ischemic stroke leading to its widespread use in rapidly triaging for IA trial enrollment. In such trials, patients who have an extracranial carotid occlusion in tandem to the intracranial target lesion are typically excluded. However, ICA terminus occlusions may be misidentified as cervical carotid occlusions on CTA. The goal of this study is to determine the accuracy of CTA in identifying ICA terminus occlusions from tandem carotid occlusions (cervical and intracranial segments). Methods: Retrospective review of a prospectively maintained database containing patients treated at our comprehensive stroke center between 1996 and 2014 in whom catheter angiogram and CT angiogram were available on PACS. A Neuroradiologist, blinded to catheter angiographic results reviewed the CT angiography identifying the presence of intracranial stenoses and concomitant cervical carotid occlusions. Results: Of 196 patients presenting with intracranial carotid occlusions on catheter based angiogram, 101 patients were identified with good quality CT angiography and subsequent catheter angiograms. Mean ages for identified patients was 65 +/- 14, of which 52% women and 48% men. Forty-four percent of patients had an ASPECT score of 9-10. The overall rate of agreement between retrospective CTA and conventional angiography readings was 77%. Of 72 isolated intracranial occlusions on conventional angiography, CT angiography misidentified 23 cervical carotid occlusions. The sensitivity of CTA for detecting isolated carotid terminus occlusion was 68% in this cohort. Specific factors associated with CT and catheter based angiographic discrepancy are reviewed. Conclusions: The study raises systematic considerations for maximizing inclusion of patients with target arterial occlusions who are most likely to benefit from intra-arterial therapy in future clinical trials. Future steps will include determination of specificity, predictive value of CTA for localization of specific carotid occlusion sites. Clinical variables associated with lower CTA accuracy will also be examined.

Sign in / Sign up

Export Citation Format

Share Document