Imaging of acute stroke prior to treatment: Current practice and evolving techniques

British Journal of Radiology

Volumn 87, Issue 1040, 2014, Pages

  Mair, G ^a   Wardlaw, J M ^a  

^a UNIVERSITY OF EDINBURGH   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

FIBRINOLYTIC AGENT;

CEREBROVASCULAR ACCIDENT; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; COMPUTER ASSISTED SCINTIGRAPHY; CONVENTIONAL ANGIOGRAPHY; HUMAN; MAGNETIC RESONANCE ANGIOGRAPHY; PATIENT ASSESSMENT; PREVALENCE; REVIEW; TREATMENT OUTCOME; DIAGNOSTIC IMAGING; DIFFERENTIAL DIAGNOSIS; FIBRINOLYTIC THERAPY; NUCLEAR MAGNETIC RESONANCE IMAGING; PROCEDURES; STROKE;

DIAGNOSIS, DIFFERENTIAL; DIAGNOSTIC IMAGING; HUMANS; MAGNETIC RESONANCE IMAGING; STROKE; THROMBOLYTIC THERAPY;

EID: 84907495130     PISSN: 00071285     EISSN: 1748880X     Source Type: Journal    
DOI: 10.1259/bjr.20140216     Document Type: Review

References (122)

1. Mathers CD, Bernand C, Iburg KM, Inoue M, Ma Fat D, Shibuya K, et al. Global burden of disease: data sources, methods and results. World Health Organization; 2004. [Cited 30 June 2014.] Available from: http://www.who.int/healthinfo/global-burden-disease/en/
2. Collaborative systematic review of the randomised trials of organised inpatient (stroke unit) care after stroke. Stroke Unit Trialists' Collaboration. BMJ 1997; 314: 1151-9.
3. Wardlaw JM, Murray V, Berge E, del Zoppo G, Sandercock P, Lindley RL, et al. Recombinant tissue plasminogen activator for acute ischaemic stroke: an updated systematic review and meta-analysis. Lancet 2012; 379: 2364-72. doi: 10.1016/S0140-6736(12)60738-7
4. The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. International Stroke Trial Collaborative Group. Lancet 1997; 349: 1569-81.
5. Dombrowski SU, Mackintosh JE, Sniehotta FF, Araujo-Soares V, Rodgers H, Thomson RG, et al. The impact of the UK "Act FAST" stroke awareness campaign: content analysis of patients, witness and primary care clinicians' perceptions. BMC Public Health 2013; 13: 915. doi: 10.1186/1471-2458-13-915
6. Saka O, McGuire A, Wolfe C. Cost of stroke in the United Kingdom. Age Ageing 2009; 38: 27-32. doi: 10.1093/ageing/afn281
7. National Institute for Health and Care Excellence (NICE). Stroke quality standard (QS2). 2010. [Cited 30 June 2014.] Available from: http://www.nice.org.uk/guidance/QS2
8. Lavy S, Melamed E, Cahane E, Carmon A. Hypertension and diabetes as risk factors in stroke patients. Stroke 1973; 4: 751-9.
9. Mori E, Yoneda Y, Tabuchi M, Yoshida T, Ohkawa S, Ohsumi Y, et al. Intravenous recombinant tissue plasminogen activator in acute carotid artery territory stroke. Neurology 1992; 42: 976-82.
10. Yamaguchi T, Hayakawa T, Kiuchi H; Japanese Thrombolysis Study Group. Intravenous tissue plasminogen activator ameliorates the outcome of hyperacute embolic stroke. Cerebrovasc Dis 1993; 3: 269-72.
11. Haley EC Jr, Brott TG, Sheppard GL, Barsan W, Broderick J, Marler JR, et al. Pilot randomized trial of tissue plasminogen activator in acute ischemic stroke. The TPA Bridging Study Group. Stroke 1993; 24: 1000-4.
12. Tissue plasminogen activator for acute ischaemic stroke. The National Institute of Neurological Disorders and Stroke (NINDS) rt-PA Stroke Study Group. N Engl J Med 1995; 333: 1581-7.
13. Hacke W, Kaste M, Fieschi C, Toni D, Lesaffre E, von Kummer R, et al. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS). JAMA 1995; 274: 1017-25.
14. Hacke W, Kaste M, Fieschi C, von Kummer R, Davalos A, Meier D, et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators. Lancet 1998; 352: 1245-51.
15. Clark WM, Wissman S, Albers GW, Jhamandas JH, Madden KP, Hamilton S. Recombinant tissue-type plasminogen activator (Alteplase) for ischemic stroke 3 to 5 hours after symptom onset. The ATLANTIS Study: a randomized controlled trial. Alteplase Thrombolysis for Acute Noninterventional Therapy in Ischemic Stroke. JAMA 1999; 282: 2019-26.
16. Clark WM, Albers GW, Madden KP, Hamilton S. The rtPA (alteplase) 0-to 6-hour acute stroke trial, part A (A0276g): results of a double-blind, placebo-controlled, multicenter study. Thromblytic therapy in acute ischemic stroke study investigators. Stroke 2000; 31: 811-16.
17. Albers GW, Clark WM, Madden KP, Hamilton SA. ATLANTIS trial: results for patients treated within 3 hours of stroke onset. Alteplase Thrombolysis for Acute Noninterventional Therapy in Ischemic Stroke. Stroke 2002; 33: 493-5.
18. Wang SY, Wang XL, Zeng H, Zuo Y, Hu N, Li XY, et al. Early intravenous thrombolysis with recombinant tissue plasminogen activator for acute cerebral infarction. [In Chinese.] Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 2003; 15: 542-5.
19. Davis SM, Donnan GA, Parsons MW, Levi C, Butcher KS, Peeters A, et al. Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): a placebo-controlled radomised trial. Lancet Neurol 2008; 7: 299-309.
20. HackeW, Kaste M, Bluhmki E, Brozman M, Dávalos A, Guidetti D, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med 2008; 359: 1317-29. doi: 10.1056/NEJMoa0804656
21. The IST-3 Collaborative Group. The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial. Lancet 2012; 379: 2352-63.
22. Wahlgren N, Ahmed N, Dávalos A, Ford GA, Grond M, Hacke W, et al. Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study. Lancet 2007; 369: 275-82. doi: 10.1016/S0140-6736(07)60149-4
23. Wahlgren N, Ahmed N, Dávalos A, Hacke W, Millan M, Muir K, et al. Thrombolysis with alteplase 3-4.5 h after acute ischaemic stroke (SITS-ISTR): an observational study. Lancet 2008; 372: 1303-9. doi: 10.1016/S0140-6736(08)61339-2
24. Ahmed N, Wahlgren N, Grond M, Hennerici M, Lees KR, Mikulik R, et al. Implementation and outcome of thrombolysis with alteplase 3-4.5 h after an acute stroke: an updated analysis from SITS-ISTR. Lancet Neurol 2010; 9: 866-74. doi: 10.1016/S1474-4422(10)70165-4
25. Ahmed N, Kellert L, Lees KR, Mikulik R, Tatlisumak T, Toni D; SITS Investigators. Results of intravenous thrombolysis within 4.5 to 6 hours and updated results within 3 to 4.5 hours of onset of acute ischemic stroke recorded in the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis Register (SITS-ISTR): an observational study. JAMA Neurol 2013; 70: 837-44.
26. Royal College of Physicians on behalf of the Intercollegiate Stroke Working Party. National Sentinel Stroke Audit Phase II (clinical audit) 2008. 2009. [Cited 30 June 2014.] Available from: https://www.rcplondon.ac.uk/sites/default/files/stroke-audit-report-2008.pdf
27. Royal College of Physicians on behalf of the Intercollegiate Stroke Working Party. Sentinel Stroke National Audit Programme (SSNAP) Clinical Audit Oct-Dec 2013 Public Report. 2014. [Cited 30 June 2014.] Available from: http://www.rcplondon.ac.uk/sites/default/files/ssnap-public-report-oct-dec-2013.pdf
28. Swain S, Turner C, Tyrrell P, Rudd A; Guideline Development Group. Diagnosis and initial management of acute stroke and transient ischaemic attack: summary of NICE guidance. BMJ 2008; 337: 291-3.
29. CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. CAST (Chinese Acute Stroke Trial) Collaborative Group. Lancet 1997; 349: 1641-9.
30. Broderick JP, Palesch YY, Demchuk AM, Yeatts SD, Khatri P, Hill MD, et al. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J Med 2013; 368: 893-903. doi: 10.1056/NEJMoa1214300
31. Kidwell CS, Jahan R, Gornbein J, Alger JR, Nenov V, Ajani Z, et al. A trial of imaging selection and endovascular treatment for ischemic stroke. N Engl J Med 2013; 368: 914-23. doi: 10.1056/NEJMoa1212793
32. Ciccone A, Valvassori L, Nichelatti M, Sgoifo A, Ponzio M, Sterzi R, et al. Endovascular treatment for acute ischemic stroke. N Engl J Med 2013; 368: 904-13. doi: 10.1056/NEJMoa1213701
33. Muir K, White P. PISTE Trial Steering Committee. Protocol 12PRT/8832: Pragmatic Ischaemic Stroke Thrombectomy Evaluation (PISTE): a randomised controlled trial (NCT01745692). 2013. [Cited 30 June 2014.] Available from: http://www.thelancet.com/protocol-reviews/12PRT-8832
34. National Institute for Health and Care Excellence (NICE). Diagnosis and initial management of acute stroke and transient ischaemic attack (TIA). Clinical Guideline CG68. 2008. [Cited 30 June 2014.] Available from: http://guidance.nice.org.uk/CG68
35. Kane I, Whiteley WN, Sandercock PA, Wardlaw JM. Availability of CT and MR for assessing patients with acute stroke. Cerebrovasc Dis 2008; 25: 375-7. doi: 10.1159/000120688
36. Wardlaw JM, Keir SL, Seymour J, Lewis S, Sandercock PA, Dennis MS, et al. What is the best imaging strategy for acute stroke? Health Technol Assess 2004; 8: 1-180.
37. Kidwell CS, Chalela JA, Saver JL, Starkman S, Hill MD, Demchuk AM, et al. Comparison of MRI and CT for detection of acute intracerebral hemorrhage. JAMA 2004; 292: 1823-30. doi: 10.1001/jama.292.15.1823
38. Mullins ME. The hyperdense cerebral artery sign on head CT scan. Semin Ultrasound CT MR 2005; 26: 394-403.
39. Jha B, Kothari M. Pearls & oy-sters: hyperdense or pseudohyperdense MCA sign: a Damocles sword? Neurology 2009; 72: e116-17.
40. Koo CK, Teasdale E, Muir KW. What constitutes a true hyperdense middle cerebral artery sign? Cerebrovasc Dis 2000; 10: 419-23.
41. Wardlaw JM, Farrall AJ, Perry D, von Kummer R, Mielke O, Moulin T, et al. Factors influencing the detection of early CT signs of cerebral ischemia: an internetbased, international multiobserver study. Stroke 2007; 38: 1250-6.
42. Kim EY, Lee SK, Kim DJ, Suh SH, Kim J, Heo JH, et al. Detection of thrombus in acute ischemic stroke: value of thin-section noncontrast-computed tomography. Stroke 2005; 36: 2754-7.
43. Wardlaw JM, von Kummer R, Farrall AJ, Chappell FM, Hill M, Perry D. A large web-based observer reliability study of early ischaemic signs on computed tomography. The Acute Cerebral CT Evaluation of Stroke Study (ACCESS). PLoS One 2010; 5: e15757. doi: 10.1371/journal.pone.0015757
44. Demchuk AM, Hill MD, Barber PA, Silver B, Patel SC, Levine SR. Importance of early ischemic computed tomography changes using ASPECTS in NINDS rtPA Stroke Study. Stroke 2005; 36: 2110-15. doi: 10.1161/01.STR.0000181116.15426.58
45. Dzialowski I, Hill MD, Coutts SB, Demchuk AM, Kent DM, Wunderlich O, et al. Extent of early ischemic changes on computed tomography (CT) before thrombolysis: prognostic value of the Alberta Stroke Program Early CT Score in ECASS II. Stroke 2006; 37: 973-8.
46. Whiteley WN, Bruins Slot K, Fernandes P, Sandercock P, Wardlaw J. Risk factors for intracranial hemorrhage in acute ischemic stroke patients treated with recombinant tissue plasminogen activator: a systematic review and meta-analysis of 55 studies. Stroke 2012; 43: 2904-9.
47. Slot KB, Berge E, Wardlaw J. Haemorrhagic transformation of a recent silent cerebral infarct during thrombolytic stroke treatment. BMJ Case Rep 2008; 2008: bcr0620080266. doi:10.1136/bcr.06.2008.0266
48. Albers GW, Lansberg MG, Norbash AM, Tong DC, O'Brien MW, Woolfenden AR, et al. Yield of diffusion-weighted MRI for detection of potentially relevant findings in stroke patients. Neurology 2000; 54: 1562-7.
49. Tsushima Y, Aoki J, Endo K. Brain microhemorrhages detected on T2∗-weighted gradient-echo MR images. AJNR Am J Neuroradiol 2003; 24: 88-96.
50. von Kummer R. Clinical efficacy of MRI in stroke. In: von Kummer R, Back T, eds. Magnetic resonance imaging in ischemic stroke. 1st edn. Berlin, Heidelberg: Springer; 2006. pp. 17-21.
51. Shoamanesh A, Kwok CS, Lim PA, Benavente OR. Postthrombolysis intracranial hemorrhage risk of cerebral microbleeds in acute stroke patients: a systematic review and meta-analysis. Int J Stroke 2013; 8: 348-56. doi: 10.1111/j.1747-4949.2012.00869.x
52. Charidimou A, Kakar P, Fox Z, Werring DJ. Cerebral microbleeds and the risk of intracerebral haemorrhage after thrombolysis for acute ischaemic stroke: systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 2013; 84: 277-80.
53. Charidimou A, Kakar P, Fox Z, Werring DJ. Cerebral microbleeds and recurrent stroke risk: systematic review and meta-analysis of prospective ischemic stroke and transient ischemic attack cohorts. Stroke 2013; 44: 995-1001. doi: 10.1161/STROKEAHA.111.000038
54. Fiebach JB, Schellinger PD, Jansen O, Meyer M, Wilde P, Bender J, et al. CT and diffusion-weighted MR imaging in randomized order: diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke 2002; 33: 2206-10.
55. Mullins ME, Schaefer PW, Sorensen AG, Halpern EF, Ay H, He J, et al. CT and conventional and diffusion-weighted MR imaging in acute stroke: study in 691 patients at presentation to the emergency department. Radiology 2002; 224: 353-60. doi: 10.1148/radiol.2242010873
56. Saur D, Kucinski T, Grzyska U, Eckert B, Eggers C, Niesen W, et al. Sensitivity and interrater agreement of CT and diffusionweighted MR imaging in hyperacute stroke. AJNR Am J Neuroradiol 2003; 24: 878-85.
57. Wardlaw JM, Smith EE, Biessels GJ, Cordonnier C, Fazekas F, Frayne R, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol 2013; 12: 822-38.
58. Wardlaw JM. Neuroimaging in acute ischaemic stroke: insights into unanswered questions of pathophysiology. J Intern Med 2010; 267: 172-90. doi: 10.1111/j.1365-2796.2009.02200.x
59. Doubal FN, Dennis MS, Wardlaw JM. Characteristics of patients with minor ischaemic strokes and negative MRI: a cross sectional study. J Neurol Neurosurg Psychiatry 2011; 82: 540-2.
60. Brazzelli M, Chappell FM, Miranda H, Shuler K, Dennis M, Sandercock PA, et al. Diffusion-weighted imaging and diagnosis of transient ischemic attack. Ann Neurol 2014; 75: 67-76. doi: 10.1002/ana.24026
61. Thomalla G, Cheng B, Ebinger M, Hao Q, Tourdias T, Wu O, et al. DWI-FLAIR mismatch for the identification of patients with acute ischaemic stroke within 4.5 h of symptom onset (PRE-FLAIR): a multicentre observational study. Lancet Neurol 2011; 10: 978-86.
62. Aoki J, Kimura K, Iguchi Y, Shibazaki K, Iwanaga T, Watanabe M, et al. Intravenous thrombolysis based on diffusion-weighted imaging and fluid-attenuated inversion recovery mismatch in acute stroke patients with unknown onset time. Cerebrovasc Dis 2011; 31: 435-41.
63. McDonald JS, Fan J, Kallmes DF, Cloft HJ. Pretreatment advanced imaging in patients with stroke treated with IV thrombolysis: evaluation of a multihospital data base. AJNR Am J Neuroradiol 2014; 35: 478-81. doi: 10.3174/ajnr.A3797
64. Kharitonova T, Thoren M, Ahmed N, Wardlaw J, von Kummer R, Thomassen L, et al. Disappearing hyperdense middle cerebral artery sign in ischaemic stroke patients treated with intravenous thrombolysis: clinical course and prognostic significance. J Neurol Neurosurg Psychiatry 2008; 80: 273-8.
65. Kharitonova T, Ahmed N, Thorén M, Wardlaw JM, von Kummer R, Glahn J, et al. Hyperdense middle cerebral artery sign on admission CTscan-prognostic significance for ischaemic stroke patients treated with intravenous thrombolysis in the safe implementation of thrombolysis in Stroke International Stroke Thrombolysis Register. Cerebrovasc Dis 2009; 27: 51-9.
66. Rha JH, Saver JL. The impact of recanalization on ischemic stroke outcome: a metaanalysis. Stroke 2007; 38: 967-73.
67. Pan J, Konstas AA, Bateman B, Ortolano GA, Pile-Spellman J. Reperfusion injury following cerebral ischemia: pathophysiology, MR imaging, and potential therapies. Neuroradiology 2007; 49: 93-102. doi: 10.1007/s00234-006-0183-z
68. Nogueira R, Liebeskind D, Gupta R, Levy E, Rai A, Barreto A, et al. Preliminary data for the dawn trial (DWI/PWI and CTP assessment in the triage of wake-up and late presenting strokes undergoing neurointervention): imaging based endovascular therapy for proximal anterior circulation occlusions beyond 8 h from last seen well in 193 stroke patients. J NeuroIntervent Surg 2009; 1: 85.
69. Ma H, Parsons MW, Christensen S, Campbell BC, Churilov L, Connelly A, et al. A multicentre, randomized, doubleblinded, placebo-controlled Phase III study to investigate EXtending the time for Thrombolysis in Emergency Neurological Deficits (EXTEND). Int J Stroke 2012; 7: 74-80.
70. Cloft HJ, Joseph GJ, Dion JE. Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a metaanalysis. Stroke 1999; 30: 317-20.
71. Kaufmann TJ, Huston J3rd, Mandrekar JN, Schleck CD, Thielen KR, Kallmes DF. Complications of diagnostic cerebral angiography: evaluation of 19,826 consecutive patients. Radiology 2007; 243: 812-19. doi: 10.1148/radiol.2433060536
72. Dawkins AA, Evans AL, Wattam J, Romanowski CA, Connolly DJ, Hodgson TJ, et al. Complications of cerebral angiography: a prospective analysis of 2,924 consecutive procedures. Neuroradiology 2007; 49: 753-9. doi: 10.1007/s00234-007-0252-y
73. Knauth M, von Kummer R, Jansen O, Hähnel S, Dörfler A, Sartor K. Potential of CT angiography in acute ischemic stroke. AJNR Am J Neuroradiol 1997; 18: 1001-10.
74. Lev MH, Farkas J, Rodriguez VR, Schwamm LH, Hunter GJ, Putman CM, et al. CT angiography in the rapid triage of patients with hyperacute stroke to intraarterial thrombolysis: accuracy in the detection of large vessel thrombus. J Comput Assist Tomogr 2001; 25: 520-8.
75. Chappell ET, Moure FC, Good MC. Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms: a metaanalysis. Neurosurgery 2003; 52: 624-31.
76. Koelemay MJ, Nederkoorn PJ, Reitsma JB, Majoie CB. Systematic review of computed tomographic angiography for assessment of carotid artery disease. Stroke 2004; 35: 2306-12. doi: 10.1161/01.STR.0000141426.63959.cc
77. Debrey SM, Yu H, Lynch JK, Lövblad KO, Wright VL, Janket SJ, et al. Diagnostic accuracy of magnetic resonance angiography for internal carotid artery disease: a systematic review and meta-analysis. Stroke 2008; 39: 2237-48. doi: 10.1161/STROKEAHA.107.509877
78. Tomanek AI, Coutts SB, Demchuk AM, Hudon ME, Morrish WE, Sevick RJ, et al. MR angiography compared to conventional selective angiography in acute stroke. Can J Neurol Sci 2006; 33: 58-62.
79. Klingebiel R, Siebert E, Diekmann S, Wiener E, Masuhr F, Wagner M, et al. 4-D Imaging in cerebrovascular disorders by using 320-slice CT: feasibility and preliminary clinical experience. Acad Radiol 2009; 16: 123-9. doi: 10.1016/j.acra.2008.11.004
80. Eddleman CS, Jeong HJ, Hurley MC, Zuehlsdorff S, Dabus G, Getch CG, et al. 4D radial acquisition contrast-enhanced MR angiography and intracranial arteriovenous malformations: quickly approaching digital subtraction angiography. Stroke 2009; 40: 2749-53.
81. Willems PW, Brouwer PA, Barfett JJ, terBrugge KG, Krings T. Detection and classification of cranial dural arteriovenous fistulas using 4D-CT angiography: initial experience. AJNR Am J Neuroradiol 2011; 32: 49-53. doi: 10.3174/ajnr.A2248
82. Qureshi AI. New grading system for angiographic evaluation of arterial occlusions and recanalization response to intra-arterial thrombolysis in acute ischemic stroke. Neurosurgery 2002; 50: 1405-14.
83. Mori E, Tabuchi M, Yoshida T, Yamadori A. Intracarotid urokinase with thromboembolic occlusion of the middle cerebral artery. Stroke 1988; 19: 802-12.
84. Wardlaw JM, von Kummer RI, Carpenter T, Parsons M, Lindley R, Cohen G, et al. Protocol for the perfusion and angiography imaging sub-study of the Third International Stroke Trial (IST-3) of alteplase treatment within six hours of acute ischemic stroke. Int J Stroke Jan 2013. Epub ahead of print. doi: 10.1111/j.1747-4949.2012.00946.x
85. Fugate JE, Klunder AM, Kallmes DF. What is meant by "TICI"? AJNR Am J Neuroradiol 2013; 34: 1792-7.
86. Zaidat OO, Yoo AJ, Khatri P, Tomsick TA, von Kummer R, Saver JL, et al. Recommendations on angiographic revascularization grading standards for acute ischemic stroke: a consensus statement. Stroke 2013; 44: 2650-63. doi: 10.1161/STROKEAHA.113.001972
87. Wintermark M, Albers GW, Broderick JP, Demchuk AM, Fiebach JB, Fiehler J, et al. Acute stroke imaging research roadmap II. Stroke 2013; 44: 2628-39. doi: 10.1161/STROKEAHA.113.002015
88. Del GA, D'Amico D, Sobesky J, Wellwood I. Accuracy of the spot sign on computed tomography angiography as a predictor of haematoma enlargement after acute spontaneous intracerebral haemorrhage: a systematic review. Cerebrovasc Dis 2014; 37: 268-76.
89. Schramm P, Schellinger PD, Klotz E, Kallenberg K, Fiebach JB, Külkens S, et al. Comparison of perfusion computed tomography and computed tomography angiography source images with perfusionweighted imaging and diffusion-weighted imaging in patients with acute stroke of less than 6 hours' duration. Stroke 2004; 35: 1652-8.
90. Camargo EC, Furie KL, Singhal AB, Roccatagliata L, Cunnane ME, Halpern EF, et al. Acute brain infarct: detection and delineation with CT angiographic source images versus nonenhanced CT scans. Radiology 2007; 244: 541-8. doi: 10.1148/radiol.2442061028
91. Coutts SB, Lev MH, Eliasziw M, Roccatagliata L, Hill MD, Schwamm LH, et al. ASPECTS on CTA source images versus unenhanced CT: added value in predicting final infarct extent and clinical outcome. Stroke 2004; 35: 2472-6. doi: 10.1161/01.STR.0000145330.14928.2a
92. Aviv RI, Shelef I, Malam S, Chakraborty S, Sahlas DJ, Tomlinson G, et al. Early stroke detection and extent: impact of experience and the role of computed tomography angiography source images. Clin Radiol 2007; 62: 447-52.
93. Alsop DC. ASL perfusion imaging: concepts and applications. ISMRM 2014. [Cited 30 June 2014] Available from: http://afni.nimh.nih.gov/sscc/staff/rwcox/ISMRM-2006/Syllabus%202006%20-%203340/files/M-09.pdf
94. Huang YC, Liu HL, Lee JD, Yang JT, Weng HH, Lee M, et al. Comparison of arterial spin labeling and dynamic susceptibility contrast perfusion MRI in patients with acute stroke. PLoS One 2013; 8: e69085. doi: 10.1371/journal.pone.0069085
95. Bivard A, Krishnamurthy V, Stanwell P, Levi C, Spratt NJ, Davis S, et al. Arterial spin labeling versus bolus-tracking perfusion in hyperacute stroke. Stroke 2014; 45: 127-33. doi: 10.1161/STROKEAHA.113.003218
96. Bivard A, Levi C, Spratt N, Parsons M. Perfusion CT in acute stroke: a comprehensive analysis of infarct and penumbra. Radiology 2013; 267: 543-50. doi: 10.1148/radiol.12120971
97. Dani KA, Thomas RG, Chappell FM, Shuler K, MacLeod MJ, Muir KW, et al. Computed tomography and magnetic resonance perfusion imaging in ischemic stroke: definitions and thresholds. Ann Neurol 2011; 70: 384-401. doi: 10.1002/ana.22500
98. Wintermark M, Reichhart M, Cuisenaire O, Maeder P, Thiran JP, Schnyder P, et al. Comparison of admission perfusion computed tomography and qualitative diffusion-and perfusion-weighted magnetic resonance imaging in acute stroke patients. Stroke 2002; 33: 2025-31.
99. Kucinski T, Naumann D, Knab R, Schoder V,Wegener S, Fiehler J, et al. Tissue at risk is overestimated in perfusion-weighted imaging: MR imaging in acute stroke patients without vessel recanalization. AJNR Am J Neuroradiol 2005; 26: 815-19.
100. Dani KA, Thomas RG, Chappell FM, Shuler K, Muir KW, Wardlaw JM. Systematic review of perfusion imaging with computed tomography and magnetic resonance in acute ischemic stroke: heterogeneity of acquisition and postprocessing parameters: a translational medicine research collaboration multicentre acute stroke imaging study. Stroke 2012; 43: 563-6.
101. Latchaw RE, Yonas H, Hunter GJ, Yuh WT, Ueda T, Sorensen AG, et al. Guidelines and recommendations for perfusion imaging in cerebral ischemia: a scientific statement for healthcare professionals by the writing group on perfusion imaging, from the Council on Cardiovascular Radiology of the American Heart Association. Stroke 2003; 34: 1084-104.
102. Saver JL. Time is brain-quantified. Stroke 2006; 37: 263-6.
103. Rowat AM, Wardlaw JM, Dennis MS, Warlow CP. Patient positioning influences oxygen saturation in the acute phase of stroke. Cerebrovasc Dis 2001; 12: 66-72.
104. Wardlaw JM, Mielke O. Early signs of brain infarction at CT: observer reliability and outcome after thrombolytic treatment-systematic review. Radiology 2005; 235: 444-53.
105. Agarwal S, Jones PS, Alawneh JA, Antoun NM, Barry PJ, Carrera E, et al. Does perfusion computed tomography facilitate clinical decision making for thrombolysis in unselected acute patients with suspected ischaemic stroke? Cerebrovasc Dis 2011; 32: 227-33.
106. van Seeters T, Biessels GJ, Niesten JM, van der Schaaf IC, Dankbaar JW, Horsch AD, et al. Reliability of visual assessment of non-contrast CT, CT angiography source images and CT perfusion in patients with suspected ischemic stroke. PLoS One 2013; 8: e75615.
107. Wintermark M, Fischbein NJ, Smith WS, Ko NU, Quist M, Dillon WP. Accuracy of dynamic perfusion CT with deconvolution in detecting acute hemispheric stroke. AJNR Am J Neuroradiol 2005; 26: 104-12.
108. Finlayson O, John V, Yeung R, Dowlatshahi D, Howard P, Zhang L, et al. Interobserver agreement of ASPECT score distribution for noncontrast CT, CT angiography, and CT perfusion in acute stroke. Stroke 2013; 44: 234-6. doi: 10.1161/STROKEAHA.112.665208
109. Girot M, Leclerc X, Gauvrit JY, Verdelho A, Pruvo JP, Leys D. Cerebral magnetic resonance imaging within 6 hours of stroke onset: inter-and intra-observer reproducibility. Cerebrovasc Dis 2003; 16: 122-7.
110. Wong KS, Lam WW, Liang E, Huang YN, Chan YL, Kay R. Variability of magnetic resonance angiography and computed tomography angiography in grading middle cerebral artery stenosis. Stroke 1996; 27: 1084-7.
111. Shrier DA, Tanaka H, Numaguchi Y, Konno S, Patel U, Shibata D. CTangiography in the evaluation of acute stroke. AJNR Am J Neuroradiol 1997; 18: 1011-20.
112. Sunshine JL, Tarr RW, Lanzieri CF, Landis DM, Selman WR, Lewin JS. Hyperacute stroke: ultrafast MR imaging to triage patients prior to therapy. Radiology 1999; 212: 325-32. doi: 10.1148/radiology.212.2.r99au52325
113. Srinivasan A, Goyal M, Lum C, Nguyen T, Miller W. Processing and interpretation times of CTangiogram and CT perfusion in stroke. Can J Neurol Sci 2005; 32: 483-6.
114. Löve A, Siemund R, Andsberg G, Cronqvist M, Holtas S, Bjorkman-Burtscher I. Comprehensive CT evaluation in acute ischemic stroke: impact on diagnosis and treatment decisions. Stroke Res Treat 2011; 2011: 726573.
115. Smith-Bindman R, Lipson J, Marcus R, Kim KP, Mahesh M, Gould R, et al. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med 2009; 169: 2078-86.
116. González RG, Furie KL, Goldmacher GV, Smith WS, Kamalian S, Payabvash S, et al. Good outcome rate of 35% in IV-tPA-treated patients with computed tomography angiography confirmed severe anterior circulation occlusive stroke. Stroke 2013; 44: 3109-13.
117. Sylaja PN, Dzialowski I, Puetz V, Eliasziw M, Hill MD, Krol A, et al. Does intravenous rtPA benefit patients in the absence of CT angiographically visible intracranial occlusion? Neurol India 2009; 57: 739-43. doi: 10.4103/0028-3886.59469
118. Kane I, Sandercock P, Wardlaw J. Magnetic resonance perfusion diffusion mismatch and thrombolysis in acute ischaemic stroke: a systematic review of the evidence to date. J Neurol Neurosurg Psychiatry 2007; 78: 485-91. doi: 10.1136/jnnp.2006.100347
119. Mishra NK, Albers GW, Davis SM, Donnan GA, Furlan AJ, Hacke W, et al. Mismatch-based delayed thrombolysis: a meta-analysis. Stroke 2010; 41: e25-33.
120. Yassi N, Parsons MW, Christensen S, Sharma G, Bivard A, Donnan GA, et al. Prediction of poststroke hemorrhagic transformation using computed tomography perfusion. Stroke 2013; 44: 3039-43. doi: 10.1161/STROKEAHA.113.002396
121. Campbell BC, Christensen S, Parsons MW, Churilov L, Desmond PM, Barber PA, et al. Advanced imaging improves prediction of hemorrhage after stroke thrombolysis. Ann Neurol 2013; 73: 510-19. doi: 10.1002/ana.23837
122. Cortijo E, Garcia-Bermejo P, Calleja AI, Pérez-Fernández S, Gómez R, Del Monte JM, et al. Intravenous thrombolysis in ischemic stroke with unknown onset using CT perfusion. Acta Neurol Scand 2013; 129: 178-83. doi: 10.1111/ane.12160