Iodinated Contrast Extravasation on Post-Revascularization Computed Tomography Mimics Magnetic Resonance Hyperintense...

Area of Science:

• Neuroimaging
• Stroke Imaging
• Reperfusion Injury

Background:

• Hyperintense reperfusion marker (HARM) on post-contrast MRI FLAIR indicates contrast extravasation after acute ischemic stroke.
• HARM signifies blood-brain barrier disruption, predicts hemorrhagic transformation, and poor clinical outcomes.

Observation:

• A patient treated with mechanical thrombectomy showed contrast extravasation on CT imaging.
• The CT findings corresponded to HARM locations identified on prior MRI.
• This suggests a potential mimicry between MRI-HARM and CT contrast extravasation.

Findings:

• MRI-HARM and CT contrast extravasation can present similarly in the context of stroke reperfusion.
• This case highlights the potential for CT imaging to serve as a surrogate biomarker.

Implications:

• Findings may allow extrapolation of HARM knowledge to CT imaging biomarkers.
• CT contrast extravasation could become a more accessible imaging biomarker for stroke patients.
• This could improve prognostication and management following stroke reperfusion therapies.