Computed Tomography Detection of Cerebral Thrombus in Acute Ischemic Stroke
Summary
Computed tomography (CT) has become an indispensable tool in the rapid identification of arterial occlusion in acute ischaemic stroke. Non-contrast CT (NCCT) enables visualisation of the hyperdense artery sign, a direct radiological marker of intravascular thrombus, while CT angiography (CTA) offers high-resolution vessel imaging and clot burden assessment. Recent technological advances, including dual-energy CT (DECT) with virtual monochromatic imaging, have enhanced contrast-to-noise ratios, improving sensitivity for subtle thrombi. Concurrently, automated image-analysis algorithms powered by deep learning now support rapid clot localisation, volume quantification and length estimation. Quantitative measures of thrombus density and morphology on CT guide decisions on intravenous thrombolysis, mechanical thrombectomy and patient selection for endovascular bridging. These developments serve to shorten door-to-needle times, tailor reperfusion strategies and predict functional outcome, underlining the global significance of CT-based thrombus detection in acute stroke pathways.
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Computed Tomography Detection of Cerebral Thrombus in Acute Ischemic Stroke publication trend
The graph below shows the total number of articles in computed tomography detection of cerebral thrombus in acute ischemic stroke across all publications each year (not limited to Nature Index journals).
Technical terms
Hyperdense artery sign: Increased attenuation of an occluded vessel on non-contrast CT indicating intravascular thrombus.
Non-contrast computed tomography (NCCT): CT imaging without intravenous contrast agents, used for rapid stroke assessment.
Computed tomography angiography (CTA): Contrast-enhanced CT technique that visualises cerebral vasculature and occlusions.
Dual-energy CT (DECT): Technique employing two X-ray energy spectra to optimise tissue contrast and virtual monochromatic imaging.
Hounsfield unit (HU): Quantitative measure of radiodensity on CT, used to characterise clot composition and vessel attenuation.
References
- Automated Intracranial Clot Detection: A Promising Tool for Vascular Occlusion Detection in Non-Enhanced CT. Diagnostics (2023).
- Correlation between acute ischaemic stroke clot length before mechanical thrombectomy and extracted clot area: Impact of thrombus size on number of passes for clot removal and final recanalization. European Stroke Journal (2021).
- Detection of Hyperdense Arterial Sign in Acute Ischemic Stroke with Dual-Energy Computed Tomography: Optimal Combination with X-ray Energy and Slice Thickness. Tomography (2024).
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