Timing-Invariant Imaging of Collateral Vessels in Acute Ischemic Stroke
Publication year
2013Source
Stroke, 44, (2013), pp. 2194-2199ISSN
Publication type
Article / Letter to editor
![https://hdl.handle.net/2066/116747](https://cdn.statically.io/img/repository.ubn.ru.nl/themes/Mirage2//images/copy.png)
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Organization
Radiology
Journal title
Stroke
Volume
vol. 44
Page start
p. 2194
Page end
p. 2199
Subject
N4i 3: Poverty-related infectious diseases ONCOL 5: Aetiology, screening and detection; ONCOL 5: Aetiology, screening and detection; Medical Imaging - Radboud University Medical Center; NCEBP 14: Cardiovascular diseases ONCOL 5: Aetiology, screening and detectionAbstract
BACKGROUND AND PURPOSE: Although collateral vessels have been shown to be an important prognostic factor in acute ischemic stroke, patients with lack of collaterals on standard imaging techniques may still have good clinical outcome. We postulate that in these cases collateral vessels are present though not visible on standard imaging techniques that are based on a single time frame. METHODS: This study included 40 consecutive patients with acute ischemic stroke with a large-vessel occlusion. Standard computed tomography angiography (CTA, single time frame) and CT perfusion (multiple time frames) were obtained at admission and timing-invariant (TI)-CTA was created from the CT perfusion data. Clinical outcome data (modified Rankin Scale) were assessed at 3-month follow-up. Four experienced observers independently assessed collateral status twice on both standard CTA and TI-CTA in an independent, blinded, randomized manner. Collateral status was rated as good if ≥50\% and poor if <50\% of collaterals were present compared with the contralateral hemisphere. RESULTS: Collateral status was rated higher on TI-CTA (good in 84\%) compared with standard CTA (good in 49\%; P<0.001). Thirty-one percent of patients with poor collateral status on standard CTA still had good clinical outcome. All of those patients, however, showed good collaterals on TI-CTA. All cases with poor collateral status rated on TI-CTA had poor clinical outcome. CONCLUSIONS: Collateral vessels may not always be visible on standard single time-frame CTA because of delayed contrast arrival. Future prognostic studies in acute stroke should consider delay-insensitive techniques, such as TI-CTA, instead of standard single time-frame imaging, such as standard CTA.
This item appears in the following Collection(s)
- Academic publications [241901]
- Electronic publications [127360]
- Faculty of Medical Sciences [91954]
- Open Access publications [102119]
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