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Prediction of the Multisegment Clot Sign on Dynamic CT Angiography of Cardioembolic Stroke

Z Chen1, F Shi1, M Zhang1

  • 1From the Department of Neurology (Z.C., F.S., M.Z., X.G., M.L.), the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.

AJNR. American Journal of Neuroradiology
|February 17, 2018
PubMed

Insights

The multisegment clot sign is more common in cardioembolic stroke than large-artery atherosclerosis stroke. This finding may help identify stroke causes and guide treatment for acute ischemic stroke.

Area of Science:

  • Neurology
  • Radiology
  • Cardiology

Background:

  • The multisegment clot sign is an imaging finding observed in acute ischemic stroke.
  • It is associated with large-artery occlusion.

Purpose of the Study:

  • To determine the occurrence rate of the multisegment clot sign.
  • To investigate its relationship with stroke etiologies in patients with acute intracranial large-artery occlusion.

Main Methods:

  • 194 patients with acute ischemic stroke and intracranial large-artery occlusion were included.
  • Dynamic CT angiography from perfusion CT was used to assess the multisegment clot sign.
  • Stroke etiologies were classified using the Trial of Org 10172 in Acute Stroke Treatment criteria.

Main Results:

  • The multisegment clot sign was present in 38% of patients.
  • It was significantly more frequent in cardioembolism (56.7%) compared to large-artery atherosclerosis (22.2%).
  • The sign showed 52.7% sensitivity and 90.7% specificity for cardioembolism.

Conclusions:

  • The multisegment clot sign on dynamic CT angiography suggests a cardiac source for intracranial large-artery occlusion.
  • This imaging marker can aid in acute stroke management and secondary prevention strategies.
Abstract

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