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Comment
. 2020 Sep;41(9):E73-E74.
doi: 10.3174/ajnr.A6670. Epub 2020 Jul 9.

Missed Medium-Vessel Occlusions on CT Angiography: Make It Easier … Easily!

J M Ospel  1   2 , W Qiu  3 , M Goyal  4   2
Affiliations
Comment

Missed Medium-Vessel Occlusions on CT Angiography: Make It Easier … Easily!

J M Ospel et al. AJNR Am J Neuroradiol. 2020 Sep.
No abstract available

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Figures

FIGURE.
FIGURE.
Patient with acute left-hemispheric symptoms (weakness of the right arm and aphasia). Multiphase CTA (arterial phase shown in A, peak-venous and late-venous phases shown in B and C) shows delayed contrast washout in the left peri-Sylvian region, which raises the suspicion of a medium-vessel occlusion. On single-phase CTA (D), it is very challenging to see the occlusion or any difference in collateral filling. Color-coded time-variant mCTA summation maps facilitate the diagnosis further because the abrupt change in vessel color on the mCTA summation map is more obvious than changes in enhancement on gray-scale images (color-coded mCTA summation map is shown in E, the black circle highlights the color changes caused by the medium vessel occlusion), vessels with maximum enhancement in the arterial phase are shown in red, those enhancing in the peak-venous and late-venous phases are shown in green and blue). The time-to-peak map derived from mCTA (F) shows a clear change of color in the affected parenchyma and is another possibility for fast and reliable detection of MeVOs.
See this image and copyright information in PMC

Comment in

  • Reply.
    Fasen BA, Kwee RM. Fasen BA, et al. AJNR Am J Neuroradiol. 2020 Sep;41(9):E75. doi: 10.3174/ajnr.A6700. Epub 2020 Jul 9. AJNR Am J Neuroradiol. 2020. PMID: 32646944 Free PMC article. No abstract available.

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References

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