Article Figures & Data
Figures
- FIG 1.
Histologic examples of various clot types. RBC-rich (A), fibrin-rich (B), platelet-rich (C) (all stained with Martius Scarlet Blue), and NET-rich (D) clots (immunohistochemistry using citrullinated H3 antibody) are shown, though standard definitions for these clot types have not yet been created.
- FIG 2.
Measurement of clot perviousness on CT using TAI. NCCT (A) demonstrates a hyperdense vessel sign in the distal left M1 (arrow), with faint attenuation in this region also seen on CTA (arrow, B). Comparison of intraclot attenuation between the NCCT (C) and CTA (D) yields a 23% increase in Hounsfield units following contrast administration.
- FIG 3.
Intracranial clot evaluation on NCCT. Both the subjective presence of a hyperdense MCA sign (arrow in A) and objective measurement of intraclot attenuation (B) are predictive the histologic composition of a clot and responsiveness to treatment. Relative attenuation, in which the involved artery is compared with the contralateral side, may also be used (not shown).
Tables
Summary of the most commonly used methods for determining clot histology and predicted treatment response on NCCT, CTA, and MR imaginga
Measurement Method Histologic Correlation Favorable Therapeutic Response NCCT HU ↑ HU = ↑ RBC, ↓ fibrin/platelets ↑ HU CTA TAI Conflicting data ↑ TAI MR imaging SVS SVS = ↑ RBC, ↓ fibrin/platelets + SVS Note:—HU indicates Hounsfield unit.
↵a Up and down arrows denote greater or lesser values (HU or TAI) and relative histologic composition. The plus sign denotes the presence of an imaging sign (ie, SVS).
