Multimodal CT imaging in ischemic stroke

Author(s):
Wijngaard, I.R. van den
Published
2017
Publication type
Doctoral Thesis

Abstract

The main objective of this thesis was to evaluate the role of new advanced multimodal CT imaging techniques in acute ischemic stroke.Important findings are that collateral assessment with dynamic CT angiography (CTA) better predicts radiological outcome and clinical outcome compared with conventional single-phase CTA. Dynamic CTA also enabled us to study dynamic cortical venous outflow in stroke which had not been described before. We have shown that venous outflow, as assessed with dynamic CTA, is a new predictor of functional outcome in acute large vesselvanterior circulation stroke. By combining the extent and velocity of optimal CVF, we observed a decreased risk of poor outcome in patients with good and fast optimal CVF. Moreover, we have demonstrated an interaction between IAT treatment effect and cortical venous filling which could potentially be useful for future treatment decision-making.

Dynamic CT angiographyStrokeTreatmentPrognosisVenous outflowCT perfusion
Defense date
2017-06-28
Language
English
Supervisor(s)
Algra, A.
Advisor(s)
Walderveen, M.A.A. van; Wermer, M.J.H.
Committee member(s)
Bom, J.G. van der; Taphoorn, M.J.B.; Buchem, M.A. van; Schonewille, W.; Zwam, W. van
Qualification
Ph.D.
Degree granting institution
Neurology and Radiology, Medicine, Leiden University, Leiden
hdl
1887/51104
ISBN(s)
9789402806472

Funding

Sponsorship
Hartstichting,St Jacobusstichting, RvB HMC, Angiocare, Scovas, Chipsoft