Ironing out differences in attenuation and blooming artifact in acute stroke thrombi

Gonzalez, Aglae Velasco; Goerlich, Dennis; Buerke, Boris; Sauerland, Cristina; Meier, Norbert; Fobker, Manfred; Mccarthy, Ray; Jeibmann, Astrid; Heindel, Walter; Faldum, Andreas; Kugel, Harald

Abstract

This study aims to improve our understanding of acute ischemic stroke clot imaging by integrating CT attenuation information with MRI susceptibility signal of thrombi. For this proof-of-principle experimental study, fifty-seven clot analogs were produced using ovine venous blood with a broad histological spectrum. Each clot analog was analyzed to determine its RBC content and chemical composition, including water, Fe III, sodium, pH, and pO2. Non-contrast CT and a susceptibility-weighted MRI sequence were used for imaging. The study found that RBC content correlated more accurately than iron content with clot attenuation on CT. There was a strong correlation between Fe III content and RBC percentage in clots. Specifically, changes in RBC content accounted for 64% of the variance in Fe III content (R2 = 0.640; p < .0001). Thrombi with blooming artifacts (BA) displayed higher attenuation on non-contrast CT than those without (73.4 vs. 40 HU, p