Purpose: Red blood cells (RBC)-poor thrombi in acute ischemic stroke (AIS) are associated with longer recanalization time for mechanical thrombectomy than RBC-rich thrombi. The purpose of the study was to differentiate between RBC-rich and RBC-poor thrombi using dual energy computed tomography (DECT).
Materials And Methods: This retrospective study was conducted on patients with acute arterial occlusion of anterior circulation who underwent DECT cerebral angiography, followed by mechanical thrombectomy with the pathological diagnosis of thrombi, dividing into RBC-rich and RBC-poor thrombi. The CT attenuation values and thrombus enhancement were measured in non-contrast scans and CTA phases at different energy levels and compared between RBC-rich and RBC-poor groups.
Results: Fourteen acute stroke patients were included in the study. There were 7 patients in RBC-rich group and 7 patients in RBC-poor group. The CT attenuation values of RBC-rich thrombi were significantly higher than those of RBC-poor thrombi at energy levels of 40, 50, 60, 70, and 80 KeV, with the most significant difference at 80 KeV ( = 0.032). A cutoff value of 44.1 Hounsfield units (HU) on 80 keV monoenergetic reconstructions was used to distinguish between RBC-rich and RBC-poor thrombi. It achieved an area under the curve (AUC) of 0.878, sensitivity of 85.7%, specificity of 100%, and accuracy of 92.9%. The degree of enhancement was higher in RBC-poor thrombi than in RBC-rich thrombi, without statistically significant difference.
Conclusion: DECT could help differentiate between RBC-rich and RBC-poor thrombi by using CT attenuation values in non-contrast phase at lower energy levels (40-80 KeV).
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588607 | PMC |
| http://dx.doi.org/10.1177/19714009221147234 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Impact of thrombus composition on virtual thrombectomy procedures using human clot analogues mechanical data.
J Mech Behav Biomed Mater
January 2025
Department of Chemistry, Materials and Chemical Engineering 'Giulio Natta', Politecnico di Milano, Italy.
Endovascular thrombectomy (EVT) aims at restoring blood flow in case of acute ischemic stroke by removing the thrombus occluding a large cerebral artery. During the procedure with stent-retriever, the thrombus is captured within the device, which is then retrieved, subjecting the thrombus to several forces, potentially leading to its fragmentation. In silico studies, along with mechanical characterisation of thrombi, can enhance our understanding of the EVT, helping the development of new devices and interventional strategies.
View Article and Find Full Text PDFAssociation between thrombus composition and first-pass recanalization after thrombectomy in acute ischemic stroke.
J Thromb Haemost
September 2024
Laboratory for Thrombosis Research, KU Leuven Kulak, Kortrijk, Belgium. Electronic address:
Article Synopsis
- Achieving first-pass recanalization (FPR) during thrombectomy is crucial for better clinical outcomes in acute ischemic stroke patients, making it important to understand the factors that cause FPR failures.
- This study examined the relationship between thrombus composition and the success rates of FPR by analyzing thrombi from 267 stroke patients.
- Results showed that thrombi leading to successful FPR had more red blood cells and less fibrin and extracellular DNA, suggesting that certain thrombus characteristics can influence the likelihood of achieving FPR.
Identifying ex vivo acute ischemic stroke thrombus composition using electrochemical impedance spectroscopy.
Interv Neuroradiol
May 2023
Department of Neurology and Neurosurgery, University of Pittsburg Medical Center, UPMC Stroke Institute, Pittsburg, PA, USA.
Article Synopsis
- - The study investigated the use of electrochemical impedance spectroscopy (EIS) combined with machine learning to analyze thrombi collected during mechanical thrombectomy (MT) for strokes, focusing on predicting red blood cell (RBC) content.
- - Researchers conducted a multicentric feasibility study, analyzing 179 thrombi and comparing EIS results with histological data, finding a strong correlation and validating EIS's predictive ability for RBC composition.
- - The method showed promising results, with sensitivity for classifying thrombi as "RBC-rich" or "RBC-poor" ranging from 77% to 85% and specificity from 72% to 88%, suggesting it could enhance strategies for stroke treatment.
Utility of dual energy CT in differentiating clot in acute ischemic stroke.
Neuroradiol J
August 2023
Division of Neurology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Purpose: Red blood cells (RBC)-poor thrombi in acute ischemic stroke (AIS) are associated with longer recanalization time for mechanical thrombectomy than RBC-rich thrombi. The purpose of the study was to differentiate between RBC-rich and RBC-poor thrombi using dual energy computed tomography (DECT).
Materials And Methods: This retrospective study was conducted on patients with acute arterial occlusion of anterior circulation who underwent DECT cerebral angiography, followed by mechanical thrombectomy with the pathological diagnosis of thrombi, dividing into RBC-rich and RBC-poor thrombi.
Deep learning prediction of stroke thrombus red blood cell content from multiparametric MRI.
Interv Neuroradiol
August 2024
Robarts Research Institute, Western University, London, Ontario, Canada.
Background And Purpose: Thrombus red blood cell (RBC) content has been shown to be a significant factor influencing the efficacy of acute ischemic stroke treatment. In this study, our objective was to evaluate the ability of convolutional neural networks (CNNs) to predict ischemic stroke thrombus RBC content using multiparametric MR images.
Materials And Methods: Retrieved stroke thrombi were scanned using a three-dimensional multi-echo gradient echo sequence and histologically analyzed.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!