Pearls and Pitfalls in CTA and CT Perfusion in Acute Ischemic Stroke: 20 Years of Experience and Still Learning

Early detection of acute stroke helps to reduce mortality rate since rapid treatment decisions can be made by clinicians. Computed tomography angiography (CTA) and CT perfusion (CTP) of the brain are two imaging procedures that are reported to be of paramount importance in the evaluation of acute stroke. Dr. Kevin Abrams reviews typical findings of acute ischemic stroke on CTA and CTP. 

Target Audience

Adult and Pediatric Neurologists, Neurosurgeons, Stroke Neurologists, Neuroradiologists, Diagnostic Radiologists, Critical Care Physicians, Neurointensivists, Emergency Medicine Physicians, Internal Medicine Physicians, Interventional Neuroradiologists, Family Physicians, General Internists, Clinical Pharmacists, Rehabilitation and Pain Management Specialists, as well as other specialists interested in the field of neuroscience.

Learning Objectives

  • Review the evolution of the use of CTA and CTP in acute ischemic stroke imaging.
  • Identify the barriers of acceptance in utilizing CTP in imaging stroke algorithm.
  • Compare typical findings of acute ischemic stroke on CTA and CTP.
  • Assess atypical CTA and CTP findings of acute ischemic stroke as well as stroke mimics.
  • Describe how CTA helps read CTP and vice versa.
  • Discuss and review the limitations and pitfalls of CTP.
Additional information
Bibliography: 
  • Fasen, B. A. C. M., Heijboer, R. J. J., Hulsmans, F. J., & Kwee, R. M. (2020). CT angiography in evaluating large-vessel occlusion in acute anterior circulation ischemic stroke: factors associated with diagnostic error in clinical practice. American Journal of Neuroradiology, 41(4), 607-611.
  • Martins, N., Aires, A., Mendez, B., Boned, S., Rubiera, M., Tomasello, A., ... & Ribó, M. (2018). Ghost infarct core and admission computed tomography perfusion: redefining the role of neuroimaging in acute ischemic stroke. Interventional neurology, 7(6), 513-521.
  • Copelan, A. Z., Smith, E. R., Drocton, G. T., Narsinh, K. H., Murph, D., Khangura, R. S., ... & Amans, M. R. (2020). Recent administration of iodinated contrast renders core infarct estimation inaccurate using RAPID software. American Journal of Neuroradiology, 41(12), 2235-2242.
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 General certificate of attendance
  • 1.00 Nurse Practitioners
  • 1.00 Florida Board of Pharmacy
Course opens: 
07/01/2021
Course expires: 
06/30/2023

Kevin Abrams, M.D.
Medical Director of Neuroradiology and MRI 
Chief of Radiology 
Baptist Hospital of Miami
Miami, Florida

Kevin Abrams, M.D., FACR, faculty for this educational event, is a consultant and shareholder for Viz. Al and Keystone Heart.  Dr. Abrams is also a shareholder for Cleerly and has indicated that the presentation or discussion will not include off-label or unapproved product usage. 

Michael McDermott, M.D., conference director for this activity, has indicated that he is a consultant with Deinde Medical and Stryker.

All of the relevant financial relationships listed for these individuals have been mitigated.

Other contributors involved in the planning, development, and editing/review of the content have no relevant financial relationships to disclose with ineligible companies.*

*Ineligible companies - Companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Disclosure Policy and Disclaimer

Baptist Health South Florida is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Baptist Health has been re-surveyed by the ACCME and awarded Commendation for 6 years as a provider of CME for physicians.
              
Baptist Health South Florida designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 General certificate of attendance
  • 1.00 Nurse Practitioners
  • 1.00 Florida Board of Pharmacy
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