Mid-cervical flame-shaped pseudo-occlusion: diagnostic performance of mid-cervical flame-shaped extracranial internal carotid artery sign on computed tomographic angiography in hyperacute ischemic stroke

被引：10

作者：

Prakkamakul, Supada ^{[1
]}

Pitakvej, Nantaporn ^{[1
]}

Dumrongpisutikul, Netsiri ^{[1
,2
]}

Lerdlum, Sukalaya ^{[1
,2
]}

机构：

[1] King Chulalongkorn Mem Hosp, Dept Radiol, Thai Red Cross Soc, 1873 Rama 4 Rd, Bangkok 10330, Thailand

[2] Chulalongkorn Univ, Dept Radiol, Fac Med, Bangkok, Thailand

来源：

NEURORADIOLOGY | 2017年 / 59卷 / 10期

关键词：

Stroke; Hyperacute; Pseudo-occlusion; Flame-shaped; CTA; CT ANGIOGRAPHY; DISSECTIONS; ARTIFACTS;

D O I：

10.1007/s00234-017-1882-3

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Flame-shaped pseudo-occlusion of the extracranial internal carotid artery (ICA) is a flow-related phenomenon that creates computed tomographic angiography (CTA) and digital subtraction angiography (DSA) findings that mimic tandem intracranial-extracranial ICA occlusion or dissection. We aim to determine the diagnostic performance of mid-cervical flame-shaped extracranial ICA sign on CTA in hyperacute ischemic stroke patients. We retrospectively included consecutive anterior circulation ischemic stroke patients presenting within 6 h of symptom onset who underwent 4D brain CTA and arterial-phase neck CTA using a 320-detector CT scanner during August 2012 to July 2015. Two blinded readers independently reviewed arterial-phase neck CTA and characterized the extracranial ICA configurations into mid-cervical flame-shaped, proximal blunt/beak-shaped, and tubular-shaped groups. 4D whole brain CTA was used as a reference standard for intracranial ICA occlusion detection. Diagnostic performance of the mid-cervical flame-shaped extracranial ICA sign and interobserver reliability were calculated. Of the 81 cases, 11 had isolated intracranial ICA occlusion, and 6 had true extracranial ICA occlusion. Mid-cervical flame-shaped extracranial ICA sign was found in 45.5% (5/11) of isolated intracranial ICA occlusions but none in the true extracranial ICA occlusion group. The sensitivity, specificity, PPV, NPV, and accuracy of the mid-cervical flame-shaped extracranial ICA sign for the detection of isolated intracranial ICA occlusion were 45.5, 100, 100, 92.1, and 92.6%, respectively. Interobserver reliability was 0.90. The mid-cervical flame-shaped extracranial ICA sign may suggest the presence of isolated intracranial ICA occlusion and allow reliable exclusion of tandem extracranial-intracranial ICA occlusion in hyperacute ischemic stroke setting.

引用

页码：989 / 996

页数：8

共 15 条

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