Differentiating Carotid Free-Floating Thrombus From Atheromatous Plaque Using Intraluminal Filling Defect Length on CTA

医学 置信区间 优势比 血栓 接收机工作特性 动脉粥样硬化 放射科 核医学 前瞻性队列研究 逻辑回归 心脏病学 血管造影 内科学
作者
Carlos Torres,Cheemun Lum,Paulo Puac,Grant Stotts,Michel Shamy,Dylan Blacquière,Ronda Lun,Prasham Dave,Aditya Bharatha,Bijoy K. Menon,Rebecca E. Thornhill,Franco Momoli,Dar Dowlatshahi
出处
期刊:Neurology [Lippincott Williams & Wilkins]
卷期号:97 (8) 被引量:17
标识
DOI:10.1212/wnl.0000000000012368
摘要

Objective

To validate a previously proposed filling defect length threshold of >3.8 mm on CT angiography (CTA) to discriminate between free-floating thrombus (FFT) and plaque of atheroma.

Methods

This was a prospective multicenter observational study of 100 participants presenting with TIA/stroke symptoms and a carotid intraluminal filling defect on initial CTA. Follow-up CTA was obtained within 1 week and at weeks 2 and 4 if the intraluminal filling defect was unchanged in length. Resolution or decreased length was diagnostic of FFT, whereas its static appearance after 4 weeks was indicative of plaque. Diagnostic accuracy of FFT length was assessed by receiver operating characteristic analysis.

Results

Ninety-five participants (mean [SD] age 68 [13] years, 61 men, 83 participants with FFT, 12 participants with a plaque) were evaluated. The >3.8-mm threshold had a sensitivity of 88% (73 of 83) (95% confidence interval [CI] 78%–94%) and specificity of 83% (10 of 12) (95% CI 51%–97%) (area under the curve 0.91, p < 0.001) for the diagnosis of FFT. The optimal length threshold was >3.64 mm with a sensitivity of 89% (74 of 83) (95% CI 80%–95%) and specificity of 83% (10 of 12) (95% CI 51%–97%). Adjusted logistic regression showed that every 1-mm increase in intraluminal filling defect length is associated with an increase in odds of FFT of 4.6 (95% CI 1.9–11.1, p = 0.01).

Conclusion

CTA enables accurate differentiation of FFT vs plaque using craniocaudal length thresholds.

Trial Registration Information

ClinicalTrials.gov Identifier: NCT02405845.

Classification of Evidence

This study provides Class I evidence that in patients with TIA/stroke symptoms, the presence of CTA-identified filling defects of lengths >3.8 mm accurately discriminates FFT from atheromatous plaque.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
赎罪完成签到 ,获得积分10
1秒前
Qsss完成签到,获得积分10
2秒前
ya发布了新的文献求助10
2秒前
2秒前
练得身形似鹤形完成签到 ,获得积分10
3秒前
3秒前
3秒前
4秒前
鹿港猫妖完成签到,获得积分20
5秒前
chen完成签到,获得积分10
5秒前
6秒前
阿湫发布了新的文献求助10
6秒前
6秒前
7秒前
崔悦欣发布了新的文献求助10
7秒前
希望天下0贩的0应助kk子采纳,获得10
8秒前
丰富的不惜完成签到,获得积分10
10秒前
票子发布了新的文献求助10
10秒前
华仔应助魏莱采纳,获得10
10秒前
F123发布了新的文献求助10
11秒前
shen发布了新的文献求助10
12秒前
12秒前
苗觉觉完成签到,获得积分10
13秒前
帕金森完成签到,获得积分10
14秒前
活力的妙芙完成签到,获得积分10
14秒前
赘婿应助疯子魔煞采纳,获得10
15秒前
橙橙橙完成签到,获得积分10
15秒前
15秒前
你好CDY完成签到,获得积分10
16秒前
16秒前
16秒前
万能图书馆应助希尔伯特采纳,获得10
16秒前
我是老大应助123采纳,获得10
17秒前
芒果小鹌鹑完成签到,获得积分10
18秒前
上官若男应助F123采纳,获得10
19秒前
Singularity应助邢文瑞采纳,获得10
20秒前
c123发布了新的文献求助10
21秒前
嘉嘉琦发布了新的文献求助10
22秒前
wanci应助QWDSA采纳,获得10
24秒前
24秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
Research on Disturbance Rejection Control Algorithm for Aerial Operation Robots 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038446
求助须知:如何正确求助?哪些是违规求助? 3576149
关于积分的说明 11374627
捐赠科研通 3305875
什么是DOI,文献DOI怎么找? 1819354
邀请新用户注册赠送积分活动 892680
科研通“疑难数据库(出版商)”最低求助积分说明 815048