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Updated: Apr 24, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Use of various CT imaging methods for diagnosis of acute ischemic cerebrovascular disease
Gang Wang1, Xue Cheng2, Xianglin Zhang1
1Department of Radiology, the First Affiliated Hospital of Liaoning Medical University, Jinzhou 121001, Liaoning Province, China.
Insights
Multi-slice CT imaging aids early diagnosis of acute ischemic cerebrovascular disease. Combining CT perfusion and angiography reveals vascular stenosis and perfusion abnormalities, improving stroke assessment.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Acute ischemic cerebrovascular disease requires prompt diagnosis and characterization.
- Cerebral infarction and transient ischemic attack share underlying vascular pathologies.
Purpose of the Study:
- To evaluate the utility of multi-slice spiral CT scan, CT perfusion imaging, and CT angiography in the early diagnosis of acute ischemic cerebrovascular disease.
- To correlate imaging findings with clinical presentation and stroke severity.
Main Methods:
- Multi-slice spiral CT scan, CT perfusion imaging, and CT angiography were performed on 52 patients (34 cerebral infarction, 18 transient ischemic attack) within 6 hours of symptom onset.
- Analysis of blood flow perfusion and vascular stenosis, including location and degree.
- Assessment using the National Institutes of Health Stroke Scale.
Main Results:
- Abnormal perfusion was detected in 29 cerebral infarction and 10 transient ischemic attack cases.
- Vascular stenosis was identified in 41 patients (33 cerebral infarction, 8 transient ischemic attack), with intracranial stenosis more common than extracranial.
- A high correlation was observed between vascular stenosis and perfusion abnormalities (83% of cases).
- Higher National Institutes of Health Stroke Scale scores correlated with increased cerebral infarction incidence.
Conclusions:
- Combined CT imaging modalities enable early diagnosis of acute ischemic cerebrovascular disease.
- These methods provide comprehensive morphological and functional insights into pathogenesis and severity.
- Early detection of stenosis and perfusion deficits is crucial for stroke management.
Abstract:
Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perfusion imaging, 29 cases in the cerebral infarction group and 10 cases in the transient ischemic attack group presented with abnormal blood flow perfusion, which corresponded to the clinical symptoms. By CT angiography, various degrees of vascular stenosis could be detected in 41 patients, including 33 in the cerebral infarction group and eight in the transient ischemic attack group. The incidence of intracranial artery stenosis was higher than that of extracranial artery stenosis. The intracranial artery stenosis was located predominantly in the middle cerebral artery and carotid artery siphon, while the extracranial artery stenosis occurred mainly in the bifurcation of the common carotid artery and the opening of the vertebral artery. There were 34 cases (83%) with convict vascular stenosis and perfusion abnormalities, and five cases (45%) with perfusion abnormalities but without convict vascular stenosis. The incidence of cerebral infarction in patients with National Institutes of Health Stroke Scale scores ≥ 5 points during onset was significantly higher than that in patients with National Institutes of Health Stroke Scale scores < 5 points. These experimental findings indicate that the combined application of various CT imaging methods allows early diagnosis of acute ischemic cerebrovascular disease, which can comprehensively analyze the pathogenesis and severity of acute ischemic cerebrovascular disease at the morphological and functional levels.
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