BACKGROUND AND PURPOSE: The goal of this study was to determine the CT findings and clinical consequences of contrast enhancement and contrast extravasation on CT scans obtained after intra-arterial thrombolytic therapy for treatment of acute ischemic stroke. METHODS: Sixty-two patients were treated with intra-arterial thrombolysis. All patients underwent nonenhanced CT scans immediately and 24 hours after thrombolytic therapy. Contrast enhancement was defined as a hyperdense lesion that disappeared on a 24-hour follow-up CT scan. Contrast extravasation was defined as a hyperdense lesion with maximum Hounsfield unit >90 that persisted on a follow-up CT scan. We evaluated the differences in the clinical and radiological data between 3 groups: contrast enhancement, contrast extravasation, and control groups. RESULTS: Contrast enhancement was found in 14 of 62 patients (22.6%); contrast extravasation was seen in 7 (11.3%). Compared with the control group, the contrast enhancement group had a lower recanalization grade (64.3% versus 34.1%, P=0.048) and a lower incidence of hemorrhagic transformation (14.3% versus 43.9%, P=0.047). The contrast extravasation group had a higher incidence of both hemorrhage (100% versus 43.9%, P=0.006) and symptomatic hemorrhage (100% versus 14.6%, P<0.001) than the control group. Poor outcomes were more frequent in the contrast extravasation group (100% versus 38.9%, P=0.003) than the control group. CONCLUSIONS: Contrast enhancement on CT scans obtained after intra-arterial thrombolysis is usually not associated with hemorrhagic complications. However, contrast extravasation is highly associated with parenchymatous hematoma and should be considered a negative prognostic sign.
BACKGROUND AND PURPOSE: The goal of this study was to determine the CT findings and clinical consequences of contrast enhancement and contrast extravasation on CT scans obtained after intra-arterial thrombolytic therapy for treatment of acute ischemic stroke. METHODS: Sixty-two patients were treated with intra-arterial thrombolysis. All patients underwent nonenhanced CT scans immediately and 24 hours after thrombolytic therapy. Contrast enhancement was defined as a hyperdense lesion that disappeared on a 24-hour follow-up CT scan. Contrast extravasation was defined as a hyperdense lesion with maximum Hounsfield unit >90 that persisted on a follow-up CT scan. We evaluated the differences in the clinical and radiological data between 3 groups: contrast enhancement, contrast extravasation, and control groups. RESULTS: Contrast enhancement was found in 14 of 62 patients (22.6%); contrast extravasation was seen in 7 (11.3%). Compared with the control group, the contrast enhancement group had a lower recanalization grade (64.3% versus 34.1%, P=0.048) and a lower incidence of hemorrhagic transformation (14.3% versus 43.9%, P=0.047). The contrast extravasation group had a higher incidence of both hemorrhage (100% versus 43.9%, P=0.006) and symptomatic hemorrhage (100% versus 14.6%, P<0.001) than the control group. Poor outcomes were more frequent in the contrast extravasation group (100% versus 38.9%, P=0.003) than the control group. CONCLUSIONS: Contrast enhancement on CT scans obtained after intra-arterial thrombolysis is usually not associated with hemorrhagic complications. However, contrast extravasation is highly associated with parenchymatous hematoma and should be considered a negative prognostic sign.
Authors: G Parrilla; B García-Villalba; M Espinosa de Rueda; J Zamarro; E Carrión; F Hernández-Fernández; J Martín; R Hernández-Clares; A Morales; A Moreno Journal: AJNR Am J Neuroradiol Date: 2012-04-26 Impact factor: 3.825
Authors: F B Cabral; L H Castro-Afonso; G S Nakiri; L M Monsignore; Src Fábio; A C Dos Santos; O M Pontes-Neto; D G Abud Journal: Interv Neuroradiol Date: 2017-09-26 Impact factor: 1.610
Authors: Matthew R Amans; Daniel L Cooke; Maya Vella; Christopher F Dowd; Van V Halbach; Randall T Higashida; Steven W Hetts Journal: Interv Neuroradiol Date: 2014-02-10 Impact factor: 1.610