title: Contrast stasis on noncontrast computed tomography as a predictor of stroke postthrombolysis.
abstract: Multimodal endovascular intervention is becoming more commonplace for the acute intervention of ischemic stroke. Hyperdensity in a portion of the treated territory is a common finding on postthrombolytic noncontrast CT (NCCT), but its significance is poorly understood. The authors conducted a single-institution, retrospective chart review of patients who had intraarterial thrombolysis of the anterior circulation between 2010 and 2011 with evidence of hyperdensity on NCCT following recanalization. Eighteen patients had evidence of postoperative contrast stasis causing hyperdensity on NCCT. One hundred percent of the patients had MR imaging evidence of completed strokes postoperatively in the same distribution as the stasis. Stasis on NCCT after intervention had a sensitivity and specificity of 82% and 0% for predicting stroke, respectively. Furthermore, the positive predictive value was 100%. The presence of contrast stasis on postthrombolytic NCCT correlates well with stroke seen on subsequent MR imaging.
authors.affiliation: Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: George M
authors.initials: GM
authors.lastname: Ghobrial
authors.forename: Anil K
authors.initials: AK
authors.lastname: Nair
authors.forename: Richard T
authors.initials: RT
authors.lastname: Dalyai
authors.forename: Pascal
authors.initials: P
authors.lastname: Jabbour
authors.forename: Stavropoula I
authors.initials: SI
authors.lastname: Tjoumakaris
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Dumont
authors.forename: Robert H
authors.initials: RH
authors.lastname: Rosenwasser
authors.forename: L Fernando
authors.initials: LF
authors.lastname: Gonzalez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control; D003287:Contrast Media / Q000493:pharmacokinetics; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects; D006801:Humans; D008297:Male; D008657:Metabolic Clearance Rate / Q000502:physiology; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D015912:Thrombolytic Therapy / Q000009:adverse effects* / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards
chemical_list: D003287:Contrast Media; D005343:Fibrinolytic Agents