2018 Volume 30 Issue 1 Pages 89-94
4-dimensional computed tomography (4D-CTA) has been developed in recent years as a technique that combines the rapid noninvasive nature of CTA with the dynamic acquisition of DSA. In clinical settings, 4D-CTA has been used for the evaluation of intracranial shunt diseases and hemorrhagic stroke, but now it is expected to play an important role for the image analysis of emergent large vessel occlusions (ELVO). At Ise Red Cross hospital, we have applied 4D-CTA to the patients suspected of ELVO using 64 row-detector scanner and shuttle mode and obtained the following critically important information on the application of mechanical thrombectomy: 1) vessel occlusion site, 2) collateral status, 3) penumbra and core, 4) clot position, length, and characteristics. Based on our experience with 432 cases subjected to emergent 4D-CTA from February 2015 to May 2017, this article shows the usefulness and feasibilities of this technique in the era of mechanical thrombectomy.
