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The prediction of successful recanalization following thrombolytic or endovascular treatment may be helpful to determine the strategy of recanalization treatment in acute stroke. Thrombus can be detected using noncontrast computed tomography (CT) as a hyperdense artery sign or blooming artifact on a T2*-weighted gradient-recalled image. The detection of thrombus using CT depends on slice thickness. Thrombus burden can be determined in terms of the length, volume, and clot burden score. The thrombus size can be quantitatively measured on thin-section CT or CT angiography/magnetic resonance angiography. The determination of thrombus size may be predictive of successful recanalization/non-recanalization after intravenous thrombolysis and endovascular treatment. However, cut-offs of thrombus size for predicting recanalization/non-recanalization are different among studies, due to different methods of measurements. Thus, a standardized method to measure the thrombus is necessary for thrombus imaging to be useful and reliable in clinical practice. Software-based measurements may provide a reliable and accurate assessment. The measurement should be easy and rapid to be more widely used in practice, which could be achieved by improvement of the user interface. In addition to prediction of recanalization, sequential measurements of thrombus volume before and after the treatment may also be useful to determine the efficacy of new thrombolytic drugs. This manuscript reviews the diagnosis of thrombus, prediction of recanalization using thrombus imaging, and practical considerations for the measurement of thrombus burden and density on CT
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참고문헌 (56)
참고문헌 신청
Strbian D / 2014 / Intravenous thrombolysis of basilar artery occlusion: thrombus length versus recanalization success / Stroke 45:1733~1738
Spiotta AM / 2013 / Hounsfield unit value and clot length in the acutely occluded vessel and time required to achieve thrombectomy, complications and outcome / J Neurointerv Surg 6:423~427
Mokin M / 2014 / Thrombus density predicts successful recanalization with Solitaire stent retriever thrombectomy in acute ischemic stroke / J Neurointerv Surg 7:104~107
Jindal G / 2014 / Relationship of thrombus length to number of stent retrievals, revascularization, and outcomes in acute ischemic stroke / J Vasc Interv Radiol 25:1549~1557
Soize S / 2015 / Susceptibility vessel sign on T2* magnetic resonance imaging and recanalization results of mechanical thrombectomy with stent retrievers: a multicentre cohort study / Eur J Neurol 22:967~972
Spiotta AM / 2013 / Hounsfield unit value and clot length in the acutely occluded vessel and time required to achieve thrombectomy, complications and outcome / J Neurointerv Surg 6:423~427
Mokin M / 2014 / Thrombus density predicts successful recanalization with Solitaire stent retriever thrombectomy in acute ischemic stroke / J Neurointerv Surg 7:104~107
Jindal G / 2014 / Relationship of thrombus length to number of stent retrievals, revascularization, and outcomes in acute ischemic stroke / J Vasc Interv Radiol 25:1549~1557
Soize S / 2015 / Susceptibility vessel sign on T2* magnetic resonance imaging and recanalization results of mechanical thrombectomy with stent retrievers: a multicentre cohort study / Eur J Neurol 22:967~972
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