Reliability and accuracy of 3-mm and 2-mm maximum intensity projection CT angiography to detect intracranial large vessel occlusion in patients with acute anterior cerebral circulation stroke

2021 ◽  
Author(s):  
Bram A. C. M. Fasen ◽  
Rob A. P. Borghans ◽  
Roeland J. J. Heijboer ◽  
Frans-Jan H. Hulsmans ◽  
Robert M. Kwee
Keyword(s):  
Ct Angiography ◽  
Cerebral Circulation ◽  
Maximum Intensity Projection ◽  
Maximum Intensity ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion

scholarly journals Utilizing CT with Maximum Intensity Projection Reconstruction Bypassing CTA Improves Time to Groin Puncture in Large Vessel Occlusion Stroke Thrombectomy

2017 ◽  
Vol 6 (3-4) ◽  
pp. 147-152 ◽  
Author(s):  
Kunakorn Atchaneeyasakul ◽  
Anita Tipirneni ◽  
Priyank Khandelwal ◽  
Vasu Saini ◽  
Richard Ronca ◽  
...  
Keyword(s):  
Thin Section ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Maximum Intensity Projection ◽  
Maximum Intensity ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Stroke Imaging

Background and Purpose: Prior to thrombectomy for proximal anterior circulation large vessel occlusion (LVO) stroke, recent trials have utilized CT angiography (CTA) for vascular imaging immediately following noncontrast CT (NCCT) for decision-making, but thin-section NCCT with automated maximum intensity projection (MIP) reconstruction also has high accuracy in demonstrating the site of an occluding thrombus. We hypothesized that performing thin-section NCCT with MIP alone prior to thrombectomy improves the time to groin puncture (GP) compared to performing CTA after NCCT. Materials and Methods: We performed a retrospective cohort study of anterior circulation LVO thrombectomy at our tertiary care academic medical center. All stroke patients evaluated with thin-section NCCT (0.625 mm) with automated MIP reconstructions alone and those who had additional CTA were included. We excluded transfer patients, in-hospital strokes, posterior circulation strokes, and patients that were evaluated with stroke imaging other than NCCT or CTA prior to thrombectomy. The study groups were compared for duration from NCCT to GP and total stroke imaging duration. Results: From March 2008 through August 2015, 34 thrombectomy patients met the inclusion/exclusion criteria - 13 in the NCCT and 20 in the NCCT+CTA group. The total stroke imaging duration was shorter in the NCCT group than in the NCCT+CTA group (2 min [1-6] vs. 28 min [23-65]; p < 0.001). The NCCT-only group had a shorter time from NCCT to GP (68 min [32-99] vs. 104 min [79-128]; p = 0.030). Conclusion: Avoiding advanced imaging for patients with anterior circulation LVO in whom thin-section NCCT with MIPs reveals a hyperdense sign significantly shortens the imaging-to-GP time.

scholarly journals Early detection of large‐vessel occlusion stroke after cardiac surgery using CT angiography leading to early recanalization with endovascular thrombectomy

2021 ◽  
Vol 9 (5) ◽  
Author(s):  
Kiyoshi Takemoto ◽  
Masaaki Sakuraya ◽  
Michitaka Nakamura ◽  
Hidetsugu Maekawa ◽  
Kazuo Yamanaka ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Early Detection ◽  
Ct Angiography ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Endovascular Thrombectomy

A quantitative analysis of CT angiography, large vessel occlusion, and thrombectomy rates in acute ischaemic stroke

2019 ◽  
Vol 74 (9) ◽  
pp. 731.e21-731.e25 ◽  
Author(s):  
E. Griffin ◽  
D. Herlihy ◽  
R. Hayden ◽  
M. Murphy ◽  
J. Walsh ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Ischaemic Stroke ◽  
Ct Angiography ◽  
Acute Ischaemic Stroke ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion

Abstract P337: RAPID-LVO for Automated Detection of Intracranial Large Vessel Occlusion in Ct Angiography of the Brain

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Seena Dehkharghani ◽  
Maarten G Lansberg ◽  
Chitra Venkatsubramanian ◽  
carlo W cereda ◽  
Fabricio O Lima ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Sensitivity And Specificity ◽  
Large Vessel ◽  
Receiver Operating Characteristics ◽  
Subspecialty Training ◽  
Emergency Setting ◽  
Large Vessel Occlusion ◽  
Operating Characteristics ◽  
Vessel Occlusion ◽  
Receiver Operating

Background: Identification of large vessel occlusion (LVO) is paramount in the urgent evaluation of acute ischemic stroke (AIS). Emergent interpretation of large and high-complexity data sets, however, may impose strains upon imaging and clinical workflows, motivating development of fast and accurate computer-aided approaches to facilitate LVO detection in the emergency setting. This study investigates the performance of a fully automated LVO detection platform in a mixed cohort of stroke subjects with and without LVO on head and neck CT angiography (CTA). Methods: CTA from two cerebrovascular trials were enriched with cases from eleven global sites. Imaging and clinical variables were balanced between populations including in LVO positivity and across demographic and imaging environments to the extent achievable. Independent and fully blinded review for intracranial ICA or MCA M1 LVO was performed by two subspecialty neuroradiologists. A novel, user-independent imaging analysis application ( RAPID-LVO , iSchemaview inc) was used to predict LVO presence, location, and overall performance relative to reader consensus. Any discordance between readers was adjudicated by a blinded tertiary reader with subspecialty training. Sensitivity, specificity, and receiver-operating characteristics were determined by an independent statistician. Performance thresholds were set a priori, including a lower bound of the 95% CI of sensitivity and specificity of ≥0.8 at mean times-to-notification <3.5 minutes. Results: 217 CTA (median age 65.5, 53% male, 109 LVO(+)) were included. Lower confidence limits of sensitivity and specificity exceeded 90% (sensitivity 0.963, 95% CI 0.909-0.986; specificity 0.981, 95% CI 0.935-0.995), surpassing pre-specified performance benchmarks. Subgroup analyses revealed no decrement in performance relative to subject age or sex, vendor systems, or location of the examination within or outside the United States. The area under the receiver operating characteristics curve was 0.99 (95% CI: 0.971-0.999) and average time-to-notification was 3.18 minutes. Conclusion: RAPID-LVO offers fast, highly accurate, and fully user-independent large vessel occlusion detection across all tested clinical and imaging environments.

Abstract WP178: “CTA for All”: Emergency CT Angiography for All Stroke Patients Presenting Within 24 Hours of Onset Improves Outcome After Large Vessel Occlusion

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Stephan Mayer ◽  
Tanuwong Viarasilpa ◽  
Nicha Panyavachiraporn ◽  
Brent Griffith ◽  
Daniel Miller ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Stroke Patients ◽  
Vessel Occlusion

Revisiting the NIH Stroke Scale as a screening tool for proximal vessel occlusion: can advanced imaging be targeted in acute stroke?

2016 ◽  
Vol 8 (12) ◽  
pp. 1208-1210 ◽  
Author(s):  
Ryan D Moore ◽  
John C Jackson ◽  
Sheila L Venkatesh ◽  
Steven D Quarfordt ◽  
Blaise W Baxter
Keyword(s):  
Ct Angiography ◽  
Vascular Occlusion ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Advanced Imaging ◽  
Vessel Occlusion ◽  
Historical Cohort ◽  
Clinical Scoring ◽  
Contrast Ct ◽  
Proximal Occlusion

Background and purposeMost patients with stroke-like symptoms screened by advanced imaging for proximal occlusion will not have a thrombus accessible by neurointerventional techniques. Development of a sensitive clinical scoring system for rapidly identifying patients with an emergent large vessel occlusion could help target limited resources and reduce exposure to unnecessary imaging.MethodsThis historical cohort study included patients who underwent non-contrast CT and CT angiography in the emergency department for stroke-like symptoms. NIH Stroke Scale (NIHSS) criteria were extended to include resolved symptoms and dichotomized as present or absent. Combinations of NIHSS criteria were considered as tests for proximal occlusion.ResultsProximal cerebral vascular occlusion was present in 19.2% (100/522) of the population and, of these, 13% (13/100) had an NIHSS score of 0. The presence on examination or history of diminished consciousness with inability to answer questions, leg weakness, dysarthria, or gaze deviation had 96% sensitivity and 39% specificity for proximal occlusion. If implemented in this population, the use of CT angiography would have been decreased by 32.4% (169/522 patients) while missing 0.76% with proximal occlusions (4/522). Half of those missed (2/4) would have been identified as large vessel infarcts on non-contrast CT, while the remainder (2/4) were transient ischemic attacks associated with carotid stenosis.ConclusionsIn this cohort, specific NIHSS criteria were highly sensitive for emergent large vessel occlusion and, if validated, may allow for clinical screening prior to advanced imaging with CT angiography.

Detection of emergent large vessel occlusion stroke with CT angiography is high across all levels of radiology training and grayscale viewing methods

2020 ◽  
Vol 30 (8) ◽  
pp. 4447-4453 ◽  
Author(s):  
Chelsea A. Boyd ◽  
Mahesh V. Jayaraman ◽  
Grayson L. Baird ◽  
William S. Einhorn ◽  
Matthew T. Stib ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Radiology Training

Detecting Large Vessel Occlusion at Multiphase CT Angiography by Using a Deep Convolutional Neural Network

Radiology ◽  
2020 ◽  
Vol 297 (3) ◽  
pp. 640-649 ◽  
Author(s):  
Matthew T. Stib ◽  
Justin Vasquez ◽  
Mary P. Dong ◽  
Yun Ho Kim ◽  
Sumera S. Subzwari ◽  
...  
Keyword(s):  
Neural Network ◽  
Convolutional Neural Network ◽  
Ct Angiography ◽  
Deep Convolutional Neural Network ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Multiphase Ct
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