医学
颈内动脉
数字减影血管造影
放射科
闭塞
血管造影
计算机断层血管造影
脑血管造影
冲程(发动机)
对比度(视觉)
核医学
心脏病学
机械工程
工程类
人工智能
计算机科学
作者
Tingyu Yi,Yi Sui,D.-N. Zheng,Xinwen Ren,Xiaoqin Lin,Yan-Min Wu,Ding-lai Lin,Zhi-nan Pan,Xiu-fen Zheng,Ganji Hong,WU Mei-hua,Lisan Zeng,Wenhuo Chen
出处
期刊:Stroke
[Ovid Technologies (Wolters Kluwer)]
日期:2024-04-01
卷期号:55 (4): 1025-1031
标识
DOI:10.1161/strokeaha.123.045156
摘要
BACKGROUND: To differentiate between pseudo occlusion (PO) and true occlusion (TO) of internal carotid artery (ICA) is important in thrombectomy treatment planning for patients with acute ischemic stroke. Although delayed contrast filling has been differentiated carotid PO from TO, its application has been limited by the implementations of multiphasic computed tomography angiography. In this study, we hypothesized that carotid ring sign, which is readily acquired from single-phasic CTA, can sufficiently differentiate carotid TO from PO. METHODS: One thousand four hundred and twenty patients with anterior circulation stroke receiving endovascular therapy were consecutively recruited through a hospital- and web-based registry. Two hundred patients with nonvisualization of the proximal ICA were included in the analysis after a retrospective screening. Diagnosis of PO or TO of the cervical segment of ICA was made based on digital subtraction angiography. Diagnostic performances of carotid ring sign on arterial-phasic CTA and delayed contrast filling on multiphasic computed tomography angiography were evaluated and compared. RESULTS: One-hundred twelve patients had ICA PO and 88 had TO. Carotid ring sign was more common in patients with TO (70.5% versus 6.3%; P <0.001), whereas delayed contrast filling was more common in PO (94.9% versus 7.7%; P <0.001). The sensitivity and specificity of carotid ring sign in diagnosing carotid TO were 0.70 and 0.94, respectively, whereas sensitivity and specificity of delayed contrast filling was 0.95 and 0.92 in judging carotid PO. CONCLUSIONS: Carotid ring sign is a potent imaging marker in diagnosing ICA TO. Carotid ring sign could be complementary to delayed contrast filling sign in differentiating TO from PO, in particular in centers with only single-phasic CTA.
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