Section 3: Imaging Protocols
It is impossible to reliably differentiate infarct from hemorrhage by clinical examination alone. Brain imaging is required to guide management, including the selection of time-sensitive acute stroke treatments. A key decision making component of EVT is based upon imaging selection with non-contrast CT (NCCT) and Multiphase Computed Tomography Angiography (CTA). ENITS has been recommended as the viewing platform for the multiphase CTA protocol. ENITS is connected to 101 Ontario hospitals and supports the emergency consultative process facilitated by CritiCall Ontario.
In 2016, the Heart and Stroke Foundations released the Key Quality Indicators for Stroke Care. The national benchmark for imaging protocols is Door to CT/CTA: ≤ 15 minutes.
Protocols / Tools
Presentations / Videos
- Automated CT Perfusion Software for Acute Ischemic Stroke Knowledge Exchange
- Dr Krings “Acute Ischemic Stroke Management and CTP” (Sep 12, 2022)
- Stratford Stroke Talk (July 14, 2016)
- EVT Presentation Drs Krings & Stotts Part 1 (July 5, 2016)
- EVT Presentation Drs Krings & Stotts Part 2 (July 5, 2016)
Websites
ASPECT in stroke (currently unavailable).
Articles
- Krol et al. (2007). Incidence of radiocontrast nephropathy in patients undergoing acute stroke computed tomography angiography. American Heart Association, 38, 2364-2366.
- Menon et al. (2015). Multiphase CT Angiography: A new tool for the imaging triage of patients with acute ischemic stroke. Radiology, 275(2), 510-520.
- Snarska et al. (2016). Renal function predicts outcomes in patients with ischaemic stroke and hemorrhagic stroke. Kidney & Blood Pressure Research, 41, 424-433.
- Hopyan et al. (2008). Renal safety of CT Angiography and perfusion imaging in the Emergency evaluation of Acute Stroke. AJNR, 29, 1826-1830.
- Smith et al. (2003). Safety and feasibility of a CT protocol for acute stroke: combined CT, CT angiography, and CT perfusion imaging in 53 consecutive patients. AJNR, 24, 688-690.