scholarly journals Delayed phase computed tomography angiography ASPECTS predicts clinical outcome and final infarct volume

PLoS ONE ◽  
2020 ◽  
Vol 15 (9) ◽  
pp. e0239510
Author(s):  
Byung Hoon Lee ◽  
Yoon Joon Hwang ◽  
Jin Woo Kim
Keyword(s):  
Computed Tomography ◽  
Clinical Outcome ◽  
Computed Tomography Angiography ◽  
Infarct Volume ◽  
Delayed Phase

scholarly journals Computed tomography angiography-based deep learning method for treatment selection and infarct volume prediction in anterior cerebral circulation large vessel occlusion

2021 ◽  
Vol 10 (11) ◽  
pp. 205846012110603
Author(s):  
Lasse Hokkinen ◽  
Teemu Mäkelä ◽  
Sauli Savolainen ◽  
Marko Kangasniemi
Keyword(s):  
Neural Network ◽  
Computed Tomography ◽  
Convolutional Neural Network ◽  
Computed Tomography Angiography ◽  
Time Window ◽  
Infarct Volume ◽  
Correlation Coefficients ◽  
Late Time ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion

Background Computed tomography perfusion (CTP) is the mainstay to determine possible eligibility for endovascular thrombectomy (EVT), but there is still a need for alternative methods in patient triage. Purpose To study the ability of a computed tomography angiography (CTA)-based convolutional neural network (CNN) method in predicting final infarct volume in patients with large vessel occlusion successfully treated with endovascular therapy. Materials and Methods The accuracy of the CTA source image-based CNN in final infarct volume prediction was evaluated against follow-up CT or MR imaging in 89 patients with anterior circulation ischemic stroke successfully treated with EVT as defined by Thrombolysis in Cerebral Infarction category 2b or 3 using Pearson correlation coefficients and intraclass correlation coefficients. Convolutional neural network performance was also compared to a commercially available CTP-based software (RAPID, iSchemaView). Results A correlation with final infarct volumes was found for both CNN and CTP-RAPID in patients presenting 6–24 h from symptom onset or last known well, with r = 0.67 ( p < 0.001) and r = 0.82 ( p < 0.001), respectively. Correlations with final infarct volumes in the early time window (0–6 h) were r = 0.43 ( p = 0.002) for the CNN and r = 0.58 ( p < 0.001) for CTP-RAPID. Compared to CTP-RAPID predictions, CNN estimated eligibility for thrombectomy according to ischemic core size in the late time window with a sensitivity of 0.38 and specificity of 0.89. Conclusion A CTA-based CNN method had moderate correlation with final infarct volumes in the late time window in patients successfully treated with EVT.

scholarly journals Improving the Evaluation of Collateral Circulation by Multiphase Computed Tomography Angiography in Acute Stroke Patients Treated with Endovascular Reperfusion Therapies

2016 ◽  
Vol 5 (3-4) ◽  
pp. 209-217 ◽  
Author(s):  
Alvaro García-Tornel ◽  
Vanessa Carvalho ◽  
Sandra Boned ◽  
Alan Flores ◽  
David Rodríguez-Luna ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Stroke ◽  
Computed Tomography Angiography ◽  
Collateral Circulation ◽  
Infarct Volume ◽  
National Institutes Of Health ◽  
Stroke Patients ◽  
Endovascular Thrombectomy ◽  
The Mean ◽  
Mean Time

Good collateral circulation (CC) is associated with favorable outcomes in acute stroke, but the best technique to evaluate collaterals is controversial. Single-phase computed tomography angiography (sCTA) is widely used but lacks temporal resolution. We aim to compare CC evaluation by sCTA and multiphase CTA (mCTA) as predictors of outcome in endovascular treated patients. Methods: Consecutive endovascular treated patients with M1 middle cerebral artery (MCA) or terminal intracranial carotid artery (TICA) occlusion confirmed by sCTA were included. Two more CTA acquisitions with 8- and 16-second delays were performed for mCTA. Endovascular thrombectomy was performed independently of the CC status according to a local protocol [Alberta Stroke Program Early CT score (ASPECTS) >6, modified Rankin scale (mRS) score <3]. CC on sCTA and mCTA were compared. Results: 108 patients were included. Their mean age was 69.6 ± 13 years and their median National Institutes of Health Stroke Scale (NIHSS) score was 17 (interquartile range 8). 79 (73.1%) had M1 MCA and 29 (26.9%) TICA occlusions. The mean time from symptom onset to CTA was 146.8 ± 96.5 min. On sCTA, 50.9% patients presented good CC vs. 57.5% on mCTA. Good CC status in both sCTA and mCTA had a lower 24-hour infarct volume (27.4 vs. 74.8 cm3 on sCTA, p = 0.04; 17.2 vs. 97.8 cm3 on mCTA, p < 0.01). However, only good CC on mCTA was associated with lower 24-hour (5 vs. 8.5, p = 0.04) and median discharge NIHSS (2 vs. 4.5, p = 0.04) scores and functional independency (mRS score <3) at 3 months (76.9 vs. 23.1%, p < 0.01). In a logistic regression model including age, NIHSS, ASPECTS and recanalization, only age (OR 0.96, 95% CI 0.93-0.99, p = 0.02) and good CC on mCTA (OR 5, 95% CI 1.99-12.6, p < 0.01) were independent predictors of functional outcome at 3 months. Conclusion: CC evaluation by mCTA is a better prognostic marker than CC evaluation by sCTA for clinical and functional endpoints in acute stroke patients treated with endovascular thrombectomy.

Mid-aortic syndrome: computed tomography angiography depicting extensive collateral circulation in an 11-year-old patient with thoracoabdominal aortic coarctation

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 132-135 ◽  
Author(s):  
Krohn ◽  
Gebauer ◽  
Hübler ◽  
Beck
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Collateral Circulation ◽  
Intestinal Ischemia ◽  
Clinical Presentation ◽  
Lower Limbs ◽  
Upper Body ◽  
Descending Aorta ◽  
Before And After ◽  
Blood Pressures

The mid-aortic syndrome is an uncommon clinical condition characterized by severe narrowing of the descending aorta, usually with involvement of its renal and visceral branches, presenting with uncontrollably elevated blood pressures of the upper body, renal and cardiac failure, intestinal ischemia, encephalopathy symptoms and claudication of the lower limbs, although clinical presentation is variable. In this article we report the case of an eleven-year-old patient with the initial diagnosis of a mid-aortic syndrome and present the computed tomography angiography pictures and reconstructions before and after surgical therapy.

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