Evaluation of an Acute Stroke Patient with Flat Detector CT Prior to Mechanical Thrombectomy

Abstract

Flat panel detectors have revolutionized tomographic imaging in the angio suite. Recent developments in hardware and software have improved soft tissue resolution and acquisition time even further, enabling soft-tissue and perfusion imaging within the angio suite. The so called "one-stop-shop" stroke imaging with flat panel detector computed tomography (FDCT) will significantly improve door to groin times and probably have an impact on patient outcome. In the presented case a patient underwent multidetector CT (MDCT) to exclude hemorrhage, then MDCT angiography (MDCTA) to identify the occluded vessel, and MDCT perfusion (MDCTP) for penumbra imaging. Patient's symptoms significantly improved during transport to the angiography suite. Thus, prior to intervention, multimodal FDCT with vessel and perfusion imaging was acquired and ultimately led to cancelation of the interventional therapy. In this clinical scenario, multimodal FDCT imaging can provide quick answers and eliminate the risk of an invasive angiography in cases of reperfusion prior to mechanical thrombectomy.

C-arm CT Perfusion Study Using Angiography System

“…Regarding the prospects of C-arm CTP using an angiography system, the "one-stop-shop" concept has been proposed. 10,13,19) Under this concept, when a patient suspected of having stroke visits a hospital, the patient is perfusion, Beuing et al and Niu et al reported that the homology with MD-CTP was favorable and it was useful to diagnose acute cerebral infarction and decide on triage. 10,14) Royalty et al also stated that a strong correlation was noted in qualitative evaluation between C-arm CTP and MD-CTP.…”