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Jun 8

CT Angiography - What Should the Rest of Us Know?

Haemin Go posted on 6/8/2021

Moderator: William A. Knight IV, MD, FACEP, FNCS
Other Participants: Achala Vagal, MD, MS

Neuroradiologist Achala Vagal, MD, discusses the fundamentals of CT Angiography for non-radiologists in podcast recorded with Dr. William Knight. Dr. Vagal decribes her techniques and approach to efficiently reviewing and interpreting a CT Angiogram of the head and neck in suspected stroke patients. Drs. Vagal and Knight review the checklist approach to minimize errors of omission, MIPS, and the challenges of difficult lesions such as M2 occlusions. They agree on optimal communication with the consulting radiologist, and discuss the benefits and pitfalls of artifical intelligence radiology software.

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2 comments on article "CT Angiography - What Should the Rest of Us Know?"

Mohammad Kassem

I'd love to hear what your personal checklists are that you have found successful when reading a CTA. Thanks!

William Knight

Great question! Here is Dr. Vagal's approach to having a systematic evaluation of CTAs - particularly for a non-radiologist:

1. Look for the LVO (ICA/M1/basilar).

2. Check the MIPs for smaller vessels such as M2

3. Check the MIPs for collaterals/decreased branching of M2 (as we know M2 occlusions are hard and easy to miss)

4. Check CTA source images for ASPECTS, especially if NCCT is normal.

Hope this helps!

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The Stroke Journey is an initiative developed by The National Stroke Education Center (NSEC) that strives to be the premier source of educational information for the diagnosis and treatment of stroke in the United States. NSEC extends the world-class educational expertise of the University of Cincinnati Department of Emergency Medicine and its partners via a variety of traditional and digital resources. NSEC and The Stroke Journey are dedicated to providing outstanding stroke education with timely material that mirrors the real-time changes in the medical education and stroke care landscape.

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Pitfalls in CTP: Why CTP Isn’t Always the Holy Grail in Acute Stroke Imaging

When Should We Consider Restarting Anticoagulation in DVT, PE and Afib Patients? What Should I Tell the Family To Be on the Look-Out for Once They Are Discharged?

What Key Lessons Have I Learned Managing Hemorrhagic Bleeding in the ICU & Critical Care?

A Review of the Different Types of Anticoagulants and Their Clinical Applications

Why Is the Extended Window Controversial and What Happened With the FDA?

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CT Angiography - What Should the Rest of Us Know?

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