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Multiphasic Computed Tomography Angiography Findings for Identifying Pseudo-Occlusion of the Internal Carotid Artery.
Stroke ( IF 8.3 ) Pub Date : 2020-06-26 , DOI: 10.1161/strokeaha.120.029512 Jai Ho Choi 1 , Jinhee Jang 2 , Jaseong Koo 3 , Kook-Jin Ahn 2 , Yong Sam Shin 1 , Bum-Soo Kim 2
Stroke ( IF 8.3 ) Pub Date : 2020-06-26 , DOI: 10.1161/strokeaha.120.029512 Jai Ho Choi 1 , Jinhee Jang 2 , Jaseong Koo 3 , Kook-Jin Ahn 2 , Yong Sam Shin 1 , Bum-Soo Kim 2
Affiliation
Background and Purpose:Differentiation between pseudo-occlusion and true occlusion of internal carotid artery (ICA) is important in treatment planning for acute ischemic stroke patients. We compared the findings of multiphasic computed tomography angiography between cervical ICA pseudo-occlusion and true occlusion at the cervical ICA in patients with anterior circulation acute ischemic stroke to determine their diagnostic value.Methods:Thirty patients with nonvisualization of the proximal ICA were included. Diagnosis of pseudo- or true occlusion of the ICA was made based on digital subtraction angiography. Diagnostic performances of multiphasic computed tomography angiography findings—(1) a flame-shaped stump and (2) delayed contrast filling at the cervical ICA— were evaluated and compared. The Fisher exact test, χ2 test, or Wilcoxon rank-sum test and McNemar test were used in the data analysis.Results:Twelve patients had true proximal ICA occlusion and 18 had pseudo-occlusion. Delayed contrast filling at the cervical ICA on multiphasic computed tomography angiography was found in all patients with pseudo-occlusion of the ICA, while 1 case of true occlusion showed delayed contrast filling (P<0.001). The presence of a flame-shaped stump was not significantly different between the pseudo- and true occlusion groups. The sensitivity of delayed contrast filling (0.94 [95% CI, 0.73–1]) was significantly higher than that of flame-shaped stump (0.75 [95% CI, 0.36–0.83]).Conclusions:We demonstrated that the delayed filling sign on multiphasic computed tomography angiography could be a useful and readily available finding for differentiating proximal ICA pseudo-occlusion from true occlusion.
中文翻译:
多相计算机断层扫描血管造影术发现,用于识别颈内动脉的伪闭塞。
背景与目的:鉴别颈内动脉(ICA)的伪闭塞与真闭塞在急性缺血性中风患者的治疗计划中很重要。我们比较了多发性计算机断层血管造影在前循环急性缺血性卒中患者颈ICA假性闭塞和真性颈ICA闭塞之间的诊断价值。方法:纳入30例近端ICA不可视的患者。基于数字减影血管造影诊断ICA的假性或真性闭塞。评估并比较了多相计算机断层血管造影结果的诊断性能-(1)火焰状树桩和(2)颈ICA延迟造影剂充盈。Fisher精确检验,χ 2结果:12例患者发生了真正的近端ICA闭塞,18例发生了假性闭塞。在所有ICA假性闭塞患者中,在多相计算机X线血管造影术中发现了颈ICA的造影剂延迟充盈,而1例真正的阻塞性病例显示了延迟的造影剂充盈(P<0.001)。在假咬合组和真实咬合组之间,火焰状树桩的存在没有显着差异。延迟造影剂填充的敏感性(0.94 [95%CI,0.73–1])显着高于火焰状树桩(0.75 [95%CI,0.36–0.83])。结论:我们证明了延迟填充征象在多相计算机体层摄影术上进行血管造影可能是有用的且容易获得的发现,可用于将近端ICA假性闭塞与真正的闭塞相区别。
更新日期:2020-07-28
中文翻译:
多相计算机断层扫描血管造影术发现,用于识别颈内动脉的伪闭塞。
背景与目的:鉴别颈内动脉(ICA)的伪闭塞与真闭塞在急性缺血性中风患者的治疗计划中很重要。我们比较了多发性计算机断层血管造影在前循环急性缺血性卒中患者颈ICA假性闭塞和真性颈ICA闭塞之间的诊断价值。方法:纳入30例近端ICA不可视的患者。基于数字减影血管造影诊断ICA的假性或真性闭塞。评估并比较了多相计算机断层血管造影结果的诊断性能-(1)火焰状树桩和(2)颈ICA延迟造影剂充盈。Fisher精确检验,χ 2结果:12例患者发生了真正的近端ICA闭塞,18例发生了假性闭塞。在所有ICA假性闭塞患者中,在多相计算机X线血管造影术中发现了颈ICA的造影剂延迟充盈,而1例真正的阻塞性病例显示了延迟的造影剂充盈(P<0.001)。在假咬合组和真实咬合组之间,火焰状树桩的存在没有显着差异。延迟造影剂填充的敏感性(0.94 [95%CI,0.73–1])显着高于火焰状树桩(0.75 [95%CI,0.36–0.83])。结论:我们证明了延迟填充征象在多相计算机体层摄影术上进行血管造影可能是有用的且容易获得的发现,可用于将近端ICA假性闭塞与真正的闭塞相区别。