The Triple Rule-Out for Acute Ischemic Stroke: Imaging the Brain, Carotid Arteries, Aorta, and Heart

Furtado, Andre D.; Adraktas, Dionesia D.; Brasic, Natasha; Cheng, SC; Ordovás, Karen; Smith, Wade S.; Lewin, Matthew R.; Chun, Krista; Chien, Jeffrey D.; Schaeffer, Sarah; Wintermark, Max

doi:10.3174/ajnr.a2075

Cited by 34 publications

(24 citation statements)

References 29 publications

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“…Souza et al (14) hypothesized that the brain regions with a relative cerebral blood flow of <0.48 and a relative mean transit time >11.3 have a higher risk of HT. The predictive ability of this method may be more effective than the magnetic resonance (MR) diffusion-weighted imaging (DWI) (15). In essence, however, this prediction method is no different from the evaluation based on the National Institutes of Health Stoke Scale score, infarct volume or collateral circulation (16).…”

Section: Applications and Development Of Permeability Imaging In Ischmentioning

confidence: 99%

Applications and development of permeability imaging in ischemic stroke (Review)

et al. 2018

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Abstract. Brain permeability imaging techniques are specific for the assessment of blood-brain barrier integrity. The present review article primarily focuses on the application of permeability imaging in cases of ischemic stroke. The permeability maps may be used to predict future hemorrhagic transformation in patients following acute ischemic stroke, that have been treated with tissue plasminogen activator (tPA) or recanalization therapy. The permeability imaging would help make the clinical decision to administer tPA following acute ischemic stroke or not, which is not only due to the current 3-4.5 h time window. Additionally, permeability imaging may also be used to evaluate the collateral circulation in the perfusion and permeability of the ischemic area of the brain.

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Section: Applications and Development Of Permeability Imaging In Ischmentioning

confidence: 99%

Applications and development of permeability imaging in ischemic stroke (Review)

et al. 2018

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“…These vessel segments include anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), anterior communicating artery (AcomA), posterior communicating artery (PcomA), basilar artery (BA), ICA, CCA, VA, innominate artery (IA), and subclavian artery (SA). For each arterial segment, image quality was graded on a 3-point scale (0= excellent, 1= good, and 2= nondiagnostic) (12). The percentage of diagnostic images was calculated by dividing the number of good or excellent vessels by the total number of assessed vessel segments.…”

Section: Image Quality Of Craniocervical Arteriesmentioning

confidence: 99%

“…The advances in latest CT technology have made single imaging of a long scan range possible (12,13). Therefore, combined CTA imaging of head, neck and aorta using dual source CT (DSCT) may also be feasible.…”

Section: Introductionmentioning

confidence: 99%

Combined CT angiography of the aorta and craniocervical artery: a new imaging protocol for assessment of acute type A aortic dissection

et al. 2017

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Background: To investigate the feasibility of combined computed tomography angiography (CTA) of the aorta and craniocervical artery in acute type A aortic dissection (ATAAD) and the value of incremental craniocervical information.Methods: Combined CTA of head, neck and aorta was performed in patients with suspected aortic dissection and 243 ATAAD patients were analyzed. The image quality and radiation dose were assessed.Valuable craniocervical CTA findings were determined for further surgical analysis.Results: The mean dose-length product (DLP) was 314.11±29.31 mGy.cm. The image quality of craniocervical arteries were 100% diagnostic. Intimal flap involving carotid arteries was detected in 47% of patients, and significant stenosis of true lumen was observed in 60% of common carotid arteries (CCAs).Hypodensity and hypoplasia/occlusion of carotid arteries were also detected and apprised surgeons. The tortuosity of carotid artery was found in 90.9% of patients. Bilateral antegrade selective cerebral perfusion (ASCP) was performed in 21.1% of aortic arch surgery based on 7 hemodynamic variation types of the circle of Willis (CW) determined by cranial CTA information.Conclusions: A combined CTA of head, neck and aorta is feasible with low radiation dose and diagnostic image quality. Incremental information on craniocervical pathology and anatomy may be useful for surgery repair of ATAAD.

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“…The attenuation values of the brain parenchyma were measured by placing an ROI of 1 cm 2 in the white matter above the lateral ventricles. Signal-to-noise ratio and contrast-to-noise ratio (CNR) were calculated by using the following formulas 13,14 :…”

Section: Objective Image-quality Evaluationmentioning

confidence: 99%

Cerebral CTA with Low Tube Voltage and Low Contrast Material Volume for Detection of Intracranial Aneurysms

Niu

Chen

Schoepf

et al. 2016

AJNR Am J Neuroradiol

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The Triple Rule-Out for Acute Ischemic Stroke: Imaging the Brain, Carotid Arteries, Aorta, and Heart

Cited by 34 publications

References 29 publications

Applications and development of permeability imaging in ischemic stroke (Review)

Applications and development of permeability imaging in ischemic stroke (Review)

Combined CT angiography of the aorta and craniocervical artery: a new imaging protocol for assessment of acute type A aortic dissection

Cerebral CTA with Low Tube Voltage and Low Contrast Material Volume for Detection of Intracranial Aneurysms

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