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stroke and CT perfusion

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https://www.readbyqxmd.com/read/28048545/we-de-207a-04-advances-in-radiological-neuro-endovascular-interventional-imaging
#1
S Rudin
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048454/we-de-207a-00-advances-in-image-guided-neurointerventions-clinical-pull-and-technology-push
#2
Jeffrey Siewerdsen, Rebecca Fahrig
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047800/we-de-207a-01-parallels-in-the-evolution-of-x-ray-angiographic-systems-and-devices-used-for-minimally-invasive-endovascular-therapy
#3
C Strother
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047144/we-de-207a-02-advances-in-cone-beam-ct-anatomical-and-functional-imaging-in-angio-suite-to-enable-one-stop-shop-stroke-imaging-workflow
#4
G Chen
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046482/we-de-207a-03-recent-advances-in-devices-used-in-neuro-interventions
#5
M Gounis
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045690/clinical-case-of-the-month-a-49-year-old-man-who-presents-with-left-sided-weakness-an-update-on-ischemic-stroke
#6
Najy Masri, Rikki Weems, Falon Brown, Ben Andres, Fred Lopez
A 49 year-old man with a past medical history significant for essential hypertension, hyperlipidemia, and coronary artery disease status post percutaneous coronary intervention and stent placement in the right coronary artery in 2010 presented for evaluation of left hemiplegia. He was feeling well until three hours prior to presentation, at which time he fell while walking from his bedroom into the kitchen. After falling, he noticed that his left upper and lower extremities felt weak. He denied any symptoms preceding the fall or any loss of consciousness...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28033184/effect-of-outflow-graft-size-on-flow-in-the-aortic-arch-and-cerebral-blood-flow-in-continuous-flow-pumps-possible-relevance-to-strokes
#7
Sindhoor Bhat, Jayakala Mathews, Komrakshi R Balakrishnan, Ramarathnam Krishna Kumar
One of the most devastating complications of continuous flow left ventricular devices (CFLVADS) is a stroke, with a higher incidence in Heartware HVAD as compared to HEARTMATE II. The reason for the observed difference in stroke rates is unclear. Since outflow graft diameters are different, we hypothesized that this could contribute to the difference in stroke rates.A Computational fluid structure interaction model was created from the CT scan of a patient. Pressures were used as the boundary condition and the flow through the cerebral vessels was derived as outputs...
December 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28028565/severe-cerebral-hypovolemia-on-perfusion-ct-and-lower-body-weight-are-associated-with-parenchymal-haemorrhage-after-thrombolysis
#8
S Tsetsou, M Amiguet, A Eskandari, R Meuli, P Maeder, B Jiang, M Wintermark, P Michel
INTRODUCTION: Haemorrhagic transformation of acute ischemic stroke (AIS) and particularly parenchymal haemorrhage (PH) remains a feared complication of intravenous thrombolysis (IVT). We aimed to identify clinical and perfusion CT (PCT) variables which are independently associated with PHs. METHODS: In this observational cohort study, based on the Acute Stroke Registry Analysis of Lausanne (ASTRAL) from 2003 to December 2013, we selected patients with AIS involving the middle cerebral artery (MCA) territory who were thrombolysed within 4...
December 27, 2016: Neuroradiology
https://www.readbyqxmd.com/read/28011374/robust-cranial-cavity-segmentation-in-ct-and-ct-perfusion-images-of-trauma-and-suspected-stroke-patients
#9
Ajay Patel, Bram van Ginneken, Frederick J A Meijer, Ewoud J van Dijk, Mathias Prokop, Rashindra Manniesing
A robust and accurate method is presented for the segmentation of the cranial cavity in computed tomography (CT) and CT perfusion (CTP) images. The method consists of multi-atlas registration with label fusion followed by a geodesic active contour levelset refinement of the segmentation. Pre-registration atlas selection based on differences in anterior skull anatomy reduces computation time whilst optimising performance. The method was evaluated on a large clinical dataset of 573 acute stroke and trauma patients that received a CT or CTP in our hospital in the period February 2015-December 2015...
December 13, 2016: Medical Image Analysis
https://www.readbyqxmd.com/read/28001316/computed-tomography-based-quantification-of-lesion-water-uptake-identifies-patients-within-4-5-hours-of-stroke-onset-a-multicenter-observational-study
#10
Jens Minnerup, Gabriel Broocks, Judith Kalkoffen, Soenke Langner, Michael Knauth, Marios Nikos Psychogios, Heike Wersching, Anja Teuber, Walter Heindel, Bernd Eckert, Heinz Wiendl, Peter Schramm, Jens Fiehler, André Kemmling
OBJECTIVE: Many patients with stroke cannot receive intravenous thrombolysis because the time of symptom onset is unknown. We tested whether computed tomography (CT)-based quantification of water uptake in the ischemic tissue can identify patients with stroke onset within 4.5 hours, the time window of thrombolysis. METHODS: Perfusion CT was used to identify ischemic brain tissue, and its density was measured in native CT and related to the density of the corresponding area of the contralateral hemisphere to quantify lesion water uptake...
December 2016: Annals of Neurology
https://www.readbyqxmd.com/read/27994572/examining-subcortical-infarcts-in-the-era-of-acute-multimodality-ct-imaging
#11
Mindy Y Q Tan, Shaloo Singhal, Henry Ma, Ronil V Chandra, Jamie Cheong, Benjamin B Clissold, John Ly, Velandai Srikanth, Thanh G Phan
BACKGROUND: Lacunar infarct has been characterized as small subcortical infarct. It is postulated to occur from "in situ microatheroma or lipohyalinosis" in small vessel or lacunar mechanism. Based on this idea, such infarcts by lacunar mechanism should not be associated with large area of perfusion deficits that extend beyond the subcortical region to the cortical region. By contrast, selected small subcortical infarcts, as defined by MR imaging in the subacute and chronic stage, may initially have large perfusion deficit or related large vessel occlusions...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27965381/opercular-index-score-a-ct-angiography-based-predictor-of-capillary-robustness-and-neurological-outcomes-in-the-endovascular-management-of-acute-ischemic-stroke
#12
Alexander Copelan, Monzer Chehab, Waleed Brinjikji, Zachary Wilseck, David F Kallmes, Jeffery Wilseck
BACKGROUND: Many CT angiography (CTA) collateral scoring systems are either subjective or complex and time consuming. OBJECTIVE: To evaluate the correlation between a CTA collateral scoring system-the Opercular Index Score (OIS)-with neurological outcomes at 90 days following endovascular treatment for acute ischemic stroke (AIS) secondary to large vessel occlusion. METHODS: Fifty-five patients with AIS due to distal internal carotid artery, M1, or proximal M2 occlusions who underwent endovascular treatment were included...
December 13, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27965285/the-impact-of-ct-perfusion-imaging-on-the-response-to-tenecteplase-in-ischemic-stroke-analysis-of-two-randomized-controlled-trials
#13
Andrew Bivard, Xuya Huang, Patrick McElduff, Christopher R Levi, Bruce C V Campbell, Bharath Kumar Cheripelli, Dheeraj Kalladka, Fiona C Moreton, Ian Ford, Christopher F Bladin, Stephen M Davis, Geoffrey A Donnan, Keith W Muir, Mark W Parsons
BACKGROUND: -We pooled two clinical trials of tenecteplase compared with alteplase for the treatment of acute ischemic stroke, one demonstrating superiority of tenecteplase, while the other showed no difference between the treatments on patient clinical outcomes. We tested the hypotheses that reperfusion therapy with tenecteplase would be superior to alteplase in improving functional outcome in the group of patients with target mismatch as identified with advanced imaging. METHODS: -We investigated if tenecteplase treated patients had a different 24h reduction in the National Institutes of Health Stroke Scale (NIHSS) and a favourable odds ratio of a modified Rankin scale (mRS) of 0-1vs 2-6 compared with alteplase treated patients using linear regression to generate odds ratios (OR)...
December 13, 2016: Circulation
https://www.readbyqxmd.com/read/27960181/stroke-mechanisms
#14
Ka Sing Wong, Louis R Caplan, Jong S Kim
Recent advances in neuroimaging technologies, such as diffusion weighted magnetic resonance imaging (MRI), perfusion weighted computed tomography (CT)/MRI, MR/CT angiography and Doppler ultrasonography allow us to determine the mechanisms of stroke and transient ischemic attack. In addition, high-resolution vessel wall MRI is nowadays increasingly used to understand the stroke mechanism in patients with intracranial atherosclerosis. Artery to artery embolism, hypoperfusion and the combination of the two are the important stroke mechanisms in patients with extracranial atherosclerosis...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27960165/benign-oligemia-in-subacute-stage-is-associated-with-borderzone-infarction-in-stroke-patients-caused-by-intracranial-large-artery-disease
#15
Jingjing Li, Xiang-Ya Chen, Yannie Soo, Thomas W Leung, Jinsheng Zeng, Ka-Sing Wong
BACKGROUND: CT perfusion (CTP) imaging provides quantitative evaluation of cerebral perfusion flow and volume. Our previous findings showed that benign oligemia caused by intracranial large artery disease may be existent in subacute stroke. AIMS: We aimed at comparing the topographic patterns and clinical outcome of stroke patients with and without persistent benign oligemia as defined by CTP imaging. METHODS: Consecutive ischemic stroke patients who were referred for CTP in 2009 were screened...
December 14, 2016: European Neurology
https://www.readbyqxmd.com/read/27935890/-surgical-prevention-of-ischaemic-strokes-by-means-of-an-extraintracranial-microanastomosis-eicma-in-the-carotid-basin
#16
V V Krylov, V A Luk'yanchikov, A S Tokarev, O Yu Nakhabin, N A Polunina, I V Sen'ko, V A Dalibaldyan, E V Grigor'eva, N E Kudryashova, G K Guseinova, E V Udodov, T A Fedulova
BACKGROUND: Not less than 50% of all ischaemic strokes appear to occur resulting from pathology of extracranial arteries. Occlusions and stenoses are more commonly encountered in carotid arteries, with the incidence of occlusion of the internal carotid artery (ICA) ranging from 5 to 10% within the structure of all lesions of brachiocephalic arteries (BCA). AIM: The study was aimed at assessing the results of a surgical procedure of extra-intracranial microanastomosis (EICMA) performed in patients presenting with occlusive and stenotic lesions of BCA at the Neurosurgical Department...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27917312/a-4d-ct-digital-phantom-of-an-individual-human-brain-for-perfusion-analysis
#17
Rashindra Manniesing, Christoph Brune, Bram van Ginneken, Mathias Prokop
Brain perfusion is of key importance to assess brain function. Modern CT scanners can acquire perfusion maps of the cerebral parenchyma in vivo at submillimeter resolution. These perfusion maps give insights into the hemodynamics of the cerebral parenchyma and are critical for example for treatment decisions in acute stroke. However, the relations between acquisition parameters, tissue attenuation curves, and perfusion values are still poorly understood and cannot be unraveled by studies involving humans because of ethical concerns...
2016: PeerJ
https://www.readbyqxmd.com/read/27891826/ct-brain-perfusion-a-static-phantom-study-of-contrast-to-noise-ratio-and-radiation-dose
#18
Stewart M Midgley, Damien L Stella, Bruce Cv Campbell, Francesca Langenberg, Paul F Einsiedel
INTRODUCTION: Computed tomography perfusion (CTP) is increasingly employed in the diagnosis and management of ischaemic stroke but radiation dose can be significant and optimising contrast-to-noise ratio (CNR) is challenging. This study aimed to quantify and optimise the balance between CNR as a surrogate for image quality and radiation dose. METHODS: A perspex head phantom with vials of dilute contrast agent was scanned using a Siemens Definition Flash 128-slice scanner...
November 27, 2016: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/27886985/efficacy-of-lens-protection-systems-dependency-on-different-cranial-ct-scans-in-the-acute-stroke-setting
#19
Nika Guberina, Michael Forsting, Adrian Ringelstein
To evaluate the dose-reduction potential with different lens protectors for patients undergoing cranial computed tomography (CT) scans. Eye lens dose was assessed in vitro (α-Al2O3:C thermoluminescence dosemeters) using an Alderson-Rando phantom(®) in cranial CT protocols at different CT scanners (SOMATOM-Definition-AS+(®)(CT1) and SOMATOM-Definition-Flash(®) (CT2)) using two different lens-protection systems (Somatex(®) (SOM) and Medical Imaging Systems(®) (MIS)). Summarised percentage of the transmitted photons: (1) CT1 (a) unenhanced CT (nCT) with gantry angulation: SOM = 103%, MIS = 111%; (2) CT2 (a) nCT without gantry angulation: SOM = 81%, MIS = 91%; (b) CT angiography (CTA) with automatic dose-modulation technique: SOM = 39%, MIS = 74%; (c) CTA without dose-modulation technique: SOM = 22%, MIS = 48%; (d) CT perfusion: SOM = 44%, MIS = 69%...
November 24, 2016: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/27879445/agreement-among-stroke-faculty-and-fellows-in-treating-ischemic-stroke-patients-with-tissue-type-plasminogen-activator-and-thrombectomy
#20
Ahmad-Riad Ramadan, Mary Carter Denny, Farhaan Vahidy, Jose-Miguel Yamal, Tzu-Ching Wu, Amrou Sarraj, Sean Savitz, James Grotta
BACKGROUND AND PURPOSE: The aim of this study is to determine agreement among vascular neurology fellows and faculty in treating patients with acute ischemic stroke with intravenous tissue-type plasminogen activator and intra-arterial thrombectomy (IAT). METHODS: Patients were evaluated simultaneously by at least 2 vascular neurology. Agreement was determined using kappa (κ) and intraclass correlation coefficients. RESULTS: In 60 patients, agreement was substantial for tissue-type plasminogen activator (κ=0...
January 2017: Stroke; a Journal of Cerebral Circulation
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