title: Intravenous flat-detector CT angiography in acute ischemic stroke management.
abstract: BACKGROUND
  In the settings of stroke, a non-invasive high-resolution imaging modality to visualize the arterial intracranial circulation in the interventional lab is a helpful mean to plan the endovascular recanalization procedure. We report our initial experience with intravenously enhanced flat-detector CT (IV FDCT) technology in the detection of obstructed intracranial arteries.
  
  
  METHODS
  Fourteen consecutive patients elected for endovascular stroke therapy underwent IV FDCT. The scans were intravenously enhanced and acquired in accordance with the previously calculated bolus arrival time. Images were processed on a commercially available workstation for reconstructions and 3D manipulation. Occlusion level and clot length, the quality of collateral vessels, and the patency of anterior and posterior communicating arteries were assessed.
  
  
  RESULTS
  IV FDCT was performed successfully in all the cases and allowed for clot location and length visualization, assessment of communicating arteries patency, and evaluation of vessel collateral grade. Information obtained from this technique was considered useful for patients treated by endovascular approach. Retrospective review of the images by two independent readers was considered accurate and reproducible.
  
  
  CONCLUSIONS
  IV FDCT technology provided accurate delineation of obstructed vessel segments in acute ischemic stroke disease. It gave a significant help in the interventional strategy. This new technology available in the operating room might provide a valuable tool in emerging endovascular stroke therapy.
authors.affiliation: Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France. rblanc@fo-rothschild.fr
authors.forename: Raphaël
authors.initials: R
authors.lastname: Blanc
authors.forename: Silvia
authors.initials: S
authors.lastname: Pistocchi
authors.forename: Drazenko
authors.initials: D
authors.lastname: Babic
authors.forename: Bruno
authors.initials: B
authors.lastname: Bartolini
authors.forename: Michaël
authors.initials: M
authors.lastname: Obadia
authors.forename: Sonia
authors.initials: S
authors.lastname: Alamowitch
authors.forename: Michel
authors.initials: M
authors.lastname: Piotin
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000628:therapy*; D002533:Cerebral Angiography / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007479:Iopamidol; D018810:Magnetic Resonance Angiography; D008297:Male; D011857:Radiographic Image Interpretation, Computer-Assisted; D020521:Stroke / Q000000981:diagnostic imaging* / Q000628:therapy*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014963:X-Ray Intensifying Screens
chemical_list: D003287:Contrast Media; D007479:Iopamidol