Article Figures & Data
Figures
- Fig 1.
Multiphase CTA and follow-up MR imaging of an 83-year-old woman presenting with acute right upper limb weakness and dysphasia. A, Axial MIP of the first phase demonstrates subtle paucity of vessels in the distribution of the left MCA compared with the right side. B, Axial MIP of the second phase demonstrates the delayed vessel sign (long arrow). There is delayed enhancement of the distal left MCA via pial collateral vessels (short arrows). This vessel is not seen on the first phase due to the presence of an M2 vessel occlusion. C, Axial MIP of the third phase also demonstrates the “delayed” left MCA vessel (long arrow). D, DWI b=1000 image 2 weeks postpresentation demonstrates a recent infarct (arrow) in the same left MCA territory.
- Fig 2.
Multiphase CTA in a 65-year-old man with acute left-sided weakness. A, Axial MIP of the first phase without obvious asymmetry. B and C, Axial MIPs of the second and third phases demonstrate the delayed vessel sign (arrow) with opacification of a distal right MCA branch, which was not opacified on the first angiographic phase due to a proximal M2 vessel occlusion. D, DWI b=1000 image 24 hours postpresentation demonstrates an acute infarct (arrow) in the same right MCA territory.
- Fig 3.
Multiphase CTA in a 78-year-old man with expressive dysphasia and right-sided weakness. A, Axial source image of the first phase of MPCTA without obvious asymmetry of the intracranial vasculature. B, The delayed vessel sign is identified on the second phase (arrow), indicative of a proximal occlusion. C, Axial source image of the third phase of the MPCTA. D–F, Axial MIPs of the first, second, and third phases of the same patient. The delayed vessel sign is more apparent on MIP image (arrow) of the second phase (E) compared with source images.
Tables
Distal Occlusions Proximal M1 Occlusions Normal Study Findings SPCTA MPCTA P Value SPCTA MPCTA P Value SPCTA MPCTA P Value Sensitivity (%) 71.7 (57.4–82.7) 100 (92.2–100) <.001 100 (83.8–100) 100 (83.8–100) NS – – – Confidence (1–5) 3.8 (3.6–4.0) 4.8 (4.6–4.9) <.001 4.6 (4.3–4.8) 5.0 .08 3.6 (3.3–3.8) 5.0 <.001 Time (sec) 99 (90–107) 44 (40–49) <.001 72 (65–79) 34 (30–37) <.001 102 (93–112) 56 (51–61) <.001 Note:—NS indicates not significant.
↵a Confidence intervals provided in parentheses.
Distal Occlusions Proximal M1 Occlusions Normal Study Findings SPCTA MPCTA P Value SPCTA MPCTA P Value SPCTA MPCTA P Value Sensitivity (%) 78.3 (64.4–87.7) 100 (92.2–100) .004 100 (83.8–100) 100 (83.8–100) NS – – – Confidence (1–5) 3.8 (3.7–4.0) 4.9 (4.8–5.0) <.001 4.7 (4.5–4.9) 5.0 .08 3.7 (3.5–3.9) 4.9 (4.7–5.0) <.001 Time (sec) 84 (78–90) 37 (34–41) <.001 67 (60–74) 29 (26–32) <.001 81 (78–85) 43 (39–47) <.001 ↵a Confidence intervals provided in parentheses.
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