Abstract
SUMMARY: Various imaging protocols exist for the identification of vessel occlusion and assessment of collateral flow in acute stroke. CT perfusion is particularly popular because the color maps are a striking visual indicator of pathology. Multiphase CTA has similar diagnostic and prognostic ability but requires more expertise to interpret. This article presents a new multiphase CTA display format that incorporates vascular information from all phases of the multiphase CTA series in a single time-variant color map, thereby facilitating multiphase CTA interpretation, particularly for less experienced readers. Exemplary cases of multiphase CTA from this new display format are compared with conventional multiphase CTA, CT perfusion, and follow-up imaging to demonstrate how time-variant multiphase CTA color maps facilitate assessment of collateral flow, detection of distal and multiple intracranial occlusions, differentiation of pseudo-occlusion from real occlusion, and assessment of flow relevance of stenoses, ante- and retrograde flow patterns, and clot permeability.
ABBREVIATIONS:
- ACA
- anterior cerebral artery
- mCTA
- multiphase CT angiography
- PCA
- posterior cerebral artery
Footnotes
Paper previously presented as an educational exhibit at: Annual Meeting of the Radiological Society of North America, December 1–6, 2019; Chicago, Illinois.
Disclosures: Johanna M. Ospel—RELATED: Grant: Freiwillige Akademische Gesellschaft Basel, Julia-Bangerter-Rhyner Foundation, University of Basel Research Foundation, Comments: research scholarships. Ondrej Volny—RELATED: Grant: National Program of Sustainability II, Czech Republic, grant No. LQ1605.* Mayank Goyal—RELATED: Other: GE Healthcare, Comments: licensing agreement for systems of acute stroke diagnosis; UNRELATED: Consultancy: Medtronic, Stryker, MicroVention, Mentice, Comments: advice on acute stroke intervention; Grants/Grants Pending: Stryker, Comments: unrestricted research grant for the UNMASK-EVT study.* Bijoy K. Menon—OTHER RELATIONSHIPS: patent on systems of triage in acute stroke, stock ownership in Circle Neurovascular. *Money paid to the institution.
- © 2020 by American Journal of Neuroradiology
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