Thrombus length discrepancy on dual-phase CT can predict clinical outcome in acute ischemic stroke
- 주제(키워드) Brain Infarction , Middle cerebral artery , Neuroimaging , Stroke , Tomography , X-Ray computed
- 등재 SCIE, SCOPUS
- 발행기관 Springer Verlag
- 발행년도 2015
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000119975
- 본문언어 영어
- Published As http://dx.doi.org/10.1007/s00330-015-4018-3
- 저작권 이화여자대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Objectives: The thrombus length may be overestimated on early arterial computed tomography angiography (CTA) depending on the collateral status. We evaluated the value of a grading system based on the thrombus length discrepancy on dual-phase CT in outcome prediction. Methods: Forty-eight acute ischemic stroke patients with M1 occlusion were included. Dual-phase CT protocol encompassed non-contrast enhanced CT, CTA with a bolus tracking technique, and delayed contrast enhanced CT (CECT) performed 40s after contrast injection. The thrombus length discrepancy between CTA and CECT was graded by using a three-point scale: G0 = no difference; G1 = no difference in thrombus length, but in attenuation distal to thrombus; G2 = difference in thrombus length. Univariate and multivariate analyses were performed to define independent predictors of poor clinical outcome at 3 months. Results: The thrombus discrepancy grade showed significant linear relationships with both the collateral status (P = 0.008) and the presence of antegrade flow on DSA (P = 0.010) with good interobserver agreement (κ = 0.868). In a multivariate model, the presence of thrombus length discrepancy (G2) was an independent predictor of poor clinical outcome [odds ratio = 11.474 (1.350–97.547); P =0.025]. Conclusions: The presence of thrombus length discrepancy on dual-phase CT may be a useful predictor of unfavourable clinical outcome in acute M1 occlusion patients. Key points: • Early arterial phase CTA may underestimate thrombus length.• Thrombus length discrepancy grade reflects collateral status or presence of antegrade flow. • Outcome prediction may be better with thrombus length grade than collateral score. © 2015 European Society of Radiology
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