J Stroke.  2016 Sep;18(3):286-296. 10.5853/jos.2016.00906.

Direct Thrombus Imaging in Stroke

• Kim J
• Park JE
• Nahrendorf M
• Kim DE

• KMID: 2359505
• DOI: http://doi.org/10.5853/jos.2016.00906

Abstract

There is an emergent need for imaging methods to better triage patients with acute stroke for tissue-plasminogen activator (tPA)-mediated thrombolysis or endovascular clot retrieval by directly visualizing the size and distribution of cerebral thromboemboli. Currently, magnetic resonance (MR) or computed tomography (CT) angiography visualizes the obstruction of blood flow within the vessel lumen rather than the thrombus itself. The present visualization method, which relies on observation of the dense artery sign (the appearance of cerebral thrombi on a non-enhanced CT), suffers from low sensitivity. When translated into the clinical setting, direct thrombus imaging is likely to enable individualized acute stroke therapy by allowing clinicians to detect the thrombus with high sensitivity, assess the size and nature of the thrombus more precisely, serially monitor the therapeutic effects of thrombolysis, and detect post-treatment recurrence. This review is intended to provide recent updates on stroke-related direct thrombus imaging using MR imaging, positron emission tomography, or CT.

Keyword

Acute stroke; Direct thrombus imaging; Positron-emission tomography; X-ray Computed Tomography; Magnetic resonance imaging, Molecular imaging

MeSH Terms

Angiography
Arteries
Humans
Magnetic Resonance Imaging
Methods
Positron-Emission Tomography
Recurrence
Stroke*
Therapeutic Uses
Thrombosis*
Tomography, X-Ray Computed
Triage
Therapeutic Uses