Cervical ICA pseudo-occlusion on single phase CTA in patients with acute terminal ICA occlusion: what is the mechanism and can delayed CTA aid diagnosis?

摘要

Background Single-phase CT angiography (CTA) forms the basis of hyperacute stroke imaging but many patients with terminal internal carotid artery (ICA) occlusion exhibit a pseudo-occlusion of the cervical ICA whereby a column of unopacified blood mimics a tandem cervical ICA lesion. We aimed to investigate the utility of a delayed phase acquisition to aid identification of a pseudo-occlusion and investigated the mechanism for this imaging artefact.