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Research ArticleBrain
Open Access

4D CT Angiography More Closely Defines Intracranial Thrombus Burden Than Single-Phase CT Angiography

A.M.J. Frölich, D. Schrader, E. Klotz, R. Schramm, K. Wasser, M. Knauth and P. Schramm
American Journal of Neuroradiology October 2013, 34 (10) 1908-1913; DOI: https://doi.org/10.3174/ajnr.A3533
A.M.J. Frölich
aFrom the Departments of Neuroradiology (A.M.J.F., D.S., R.S., M.K., P.S.)
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D. Schrader
aFrom the Departments of Neuroradiology (A.M.J.F., D.S., R.S., M.K., P.S.)
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E. Klotz
cSiemens AG (E.K.), Healthcare Sector, Computed Tomography, Forchheim, Germany.
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R. Schramm
aFrom the Departments of Neuroradiology (A.M.J.F., D.S., R.S., M.K., P.S.)
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K. Wasser
bNeurology (K.W.), University Medical Center Göttingen, Göttingen, Germany
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M. Knauth
aFrom the Departments of Neuroradiology (A.M.J.F., D.S., R.S., M.K., P.S.)
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P. Schramm
aFrom the Departments of Neuroradiology (A.M.J.F., D.S., R.S., M.K., P.S.)
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    Fig 1.

    Assessment of clot burden. A, Coronal spCTA maximum intensity projection in a patient with left-sided middle cerebral artery occlusion shows lack of opacification of the entire M1 segment (4 points) as well as M2 segments (1 point each), resulting in a CBS of 4. B, The corresponding tMIP reveals delayed filling of the very distal M1 as wells as M2 segments (arrow). Raters defined only the proximal M1 as occluded and assigned a CBS of 8.

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    Fig 2.

    Filling defects and hyperattenuated clot. A, Axial spCTA maximum intensity projection shows a right-sided middle cerebral artery occlusion (arrow). B, On the corresponding tMIP, the occluding thrombus is well visualized as a filling defect. C, Axial thin-section image from the nonenhanced phase of the CTP scan shows an HMCAS matching this filling defect.

  • Fig 3.
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    Fig 3.

    Measuring clot length. Bland-Altman plots illustrate the comparative precision of filling defects on spCTA (A) and on tMIP (B) in predicting the length of the HMCAS.

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American Journal of Neuroradiology: 34 (10)
American Journal of Neuroradiology
Vol. 34, Issue 10
1 Oct 2013
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4D CT Angiography More Closely Defines Intracranial Thrombus Burden Than Single-Phase CT Angiography
A.M.J. Frölich, D. Schrader, E. Klotz, R. Schramm, K. Wasser, M. Knauth, P. Schramm
American Journal of Neuroradiology Oct 2013, 34 (10) 1908-1913; DOI: 10.3174/ajnr.A3533

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4D CT Angiography More Closely Defines Intracranial Thrombus Burden Than Single-Phase CT Angiography
A.M.J. Frölich, D. Schrader, E. Klotz, R. Schramm, K. Wasser, M. Knauth, P. Schramm
American Journal of Neuroradiology Oct 2013, 34 (10) 1908-1913; DOI: 10.3174/ajnr.A3533
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