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CTA Source Images as a Predictor of Final Infarct Volume are Time-Dependent

Published online by Cambridge University Press:  23 September 2016

Dylan Blacquiere*
Affiliation:
Department of Medicine — Division of Neurology, The University of Ottawa
Miguel Bussière
Affiliation:
Department of Medicine — Division of Neurology, The University of Ottawa Department of Diagnostic Imaging — Diagnostic and Interventional Neuroradiology Section, The Ottawa Hospital, Ottawa, Ontario, Canada
Cheemun Lum
Affiliation:
Department of Diagnostic Imaging — Diagnostic and Interventional Neuroradiology Section, The Ottawa Hospital, Ottawa, Ontario, Canada
Dar Dowlatshahi
Affiliation:
Department of Medicine — Division of Neurology, The University of Ottawa
*
Department of Medicine — Division of Neurology, University of Ottawa, The Ottawa Hospital, Civic Campus, Room 2196b, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9, Canada
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Avascularity on CT angiography source images (CTASI) may better predict final infarct volume in acute stroke as compared to early ischemic changes on non-contract CT. These CTASI findings may represent infarct core and help determine the extent of salvageable tissue. However, the extent of avascularity on CTASI may overestimate infarct volume if transit of contrast is prolonged due to proximal artery occlusion. We present a case where CT-perfusion (CTP) and time-resolved CT-angiography (CTA) identified salvageable tissue thought to be infarcted on CTASI.

Type
Neuroimaging Highlights
Copyright
Copyright © The Canadian Journal of Neurological 2010

References

1. Coutts, SB, Lev, MH, Eliaszew, M, et al. ASPECTS on CTA source images versus unenhanced CT added v Value in predicting final infarct extent and clinical outcome. Stroke. 2004; 35:2472–6.CrossRefGoogle Scholar
2. Schramm, P, Schellinger, PD, Fiebach, JB, et al. Comparison of CT and CT angiography source images with diffusion weighted imaging in patients with acute stroke within 6 hours after onset. Stroke. 2002; 33:2426–32.CrossRefGoogle Scholar
3. Camargo, EC, Furie, KL, Singhal, AB, et al. Acute brain infarct: detection and delineation with CT angiographic source images versus nonenhanced CT scans. Radiology. 2007; 244:541–8.CrossRefGoogle Scholar
4. Lin, K, Rapalino, O, Law, M, Babb, JS, Siller, KA, Pramanik, BK. Accuracy of the Alberta stroke program early CT score during the first 3 hours of middle cerebral artery stroke: comparison of noncontrast CT, CT angiography source images, and CT perfusion. AJNR Am J Neuroradiol. 2008; 29:931–6.CrossRefGoogle ScholarPubMed
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