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Association Between Thrombus Perviousness Assessed on Computed Tomography and Stroke Cause

Anna Kufner1,2,3, Hebun Erdur1,2, Matthias Endres1,2,3,4,5

  • 1Klinik und Hochschulambulanz für Neurologie (A.K., H.E., M.E., C.H.N., L.S.).

Stroke
|October 1, 2020
PubMed

Insights

Thrombus perviousness (TP) measured on CT scans can help identify cardioembolic stroke. This imaging marker, thrombus attenuation increase, shows high specificity for cardioembolic stroke, aiding in secondary prevention strategies.

Area of Science:

  • Neurology
  • Radiology
  • Cardiology

Background:

  • Thrombus perviousness (TP) is a novel imaging marker assessed via noncontrast computed tomography (NCCT) and CT angiography.
  • Previous studies suggest TP may be highly specific for identifying cardioembolic stroke.
  • The factors influencing TP and its diagnostic accuracy require further investigation.

Purpose of the Study:

  • To identify clinical and laboratory parameters affecting thrombus perviousness (TP) measurements.
  • To validate the diagnostic accuracy of TP in an independent cohort of acute ischemic stroke patients.
  • To determine if TP can differentiate cardioembolic stroke from other stroke etiologies.

Main Methods:

  • Retrospective analysis of 75 patients with middle cerebral artery (M1) occlusions.
  • Segmentation of thrombi on coregistered NCCT and CT angiography.
  • Calculation of thrombus attenuation increase and void fraction to quantify TP.

Main Results:

  • TP measures were significantly higher in cardioembolic stroke patients compared to large artery atherosclerosis stroke patients (P=0.001).
  • Only stroke cause, not clinical or laboratory parameters, was significantly associated with TP.
  • Thrombus attenuation increase independently predicted cardioembolic stroke (OR=1.12, P=0.004) with 100% specificity at a cutoff of 6.23 HU.

Conclusions:

  • TP assessment on baseline CT angiography in M1 occlusion may help determine cardioembolic stroke cause.
  • TP measures can guide secondary prevention strategies for stroke patients.
  • Clinical and laboratory parameters, excluding stroke cause, did not significantly influence TP.
Abstract

Keywords:
angiographyatherosclerosismiddle cerebral arterysecondary preventiontomography

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