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|Title:||Perfusion-derived dynamic 4D CT angiography identifies carotid pseudo-occlusion in hyperacute stroke.|
|Epworth Authors:||Gilligan, Amanda|
|Other Authors:||Ng, F. C.|
Choi, P. M.
4-Dimensional CT Angiogram
Extracranial Internal Carotid Artery
Acute Tandem Occlusion
Neurosciences Clinical Institute, Epworth HealthCare, Victoria, Australia
|Publisher:||Wiley Online Library|
|Citation:||J Neuroimaging. 2016 Nov;26(6):588-591. doi: 10.1111/jon.12375|
|Abstract:||BACKGROUND: Differentiation between true acute tandem occlusion involving the extracranial internal carotid artery (ICA) from pseudotandem occlusion with a patent extracranial ICA has important prognostic and therapeutic implications. We explored the utility of perfusion-derived 4-dimensional CT angiogram (4D-CTA) in identifying carotid pseudo-occlusion in a single-center pilot study. METHODS: Acute stroke patients with delayed antegrade ICA flow on 4D-CTA despite an apparent tandem occlusion on conventional single-phase CTA were prospectively identified over a 2.5-year period (2013-2015). RESULTS: Eight patients were identified. Delayed antegrade intracranial flow from the apparently occluded ICA was detected up to 50 seconds after contrast administration on 4D-CTA. The distal intracranial ICA was the most common site of true occlusion. Reconstruction of the 4D-CTA images required an additional processing time of 2-3 minutes. CONCLUSIONS: 4D-CTA is a novel noninvasive technique that can identify carotid pseudo-occlusion in the acute stroke setting. Our preliminary findings suggest that 4D-CTA can be easily incorporated into an existing acute stroke neuroimaging protocol.|
|Journal Title:||Journal of Neuroimaging|
|Affiliated Organisations:||Department of Neurosciences, Box Hill Hospital, Melbourne, Victoria, Australia.|
Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Department of Medical Imaging, Box Hill Hospital, Melbourne, Victoria, Australia.
|Type of Clinical Study or Trial:||Observational Study|
|Appears in Collections:||Diagnostic Services|
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