Multiphase CT Angiogram for Stroke Diagnosis
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Solution Overview
Problem
Current stroke diagnosis methods, particularly for ischemic strokes, are time-consuming and lack sufficient information about arterial collaterals, leading to delayed treatment decisions that can result in significant neural circuitry loss and variable treatment outcomes. Additionally, existing methods are prone to patient motion artifacts, radiation exposure, and variability across different treatment centers and CT machines.
Innovation Solution
The implementation of multiphase CT angiogram (mCTA) techniques, which involve conducting multiple CT angiograms over a condensed period with defined intervals to provide time-sequenced images, enabling the assessment of contrast density trends and collateral maps to aid in diagnosing and treating strokes by determining occlusions, clot properties, and hemorrhagic leaks.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of information
If multiple CT angiograms are conducted over a condensed period with defined intervals, then diagnostic information about arterial collaterals and contrast density trends is improved, but radiation exposure increases
Solution Approach 1:
The diagnostic process is segmented into multiple discrete CT angiogram phases conducted at defined intervals (e.g., 0, 15, 30, 45 seconds). Each phase captures contrast density at a specific time point, and the segmentation allows reconstruction of temporal contrast density trends and collateral flow patterns without requiring continuous imaging, thereby limiting total radiation exposure while obtaining sufficient diagnostic information.
Solution Approach 2:
CT angiograms are performed periodically at predetermined time intervals rather than continuously. This periodic imaging approach captures the dynamic flow of contrast through arterial collaterals at critical moments, enabling assessment of collateral perfusion and contrast density trends while minimizing the cumulative radiation dose by avoiding unnecessary intermediate scans.
2Loss of time
If multiple CT angiograms are conducted over a condensed period with defined intervals, then diagnostic time is reduced, but device complexity and protocol management increase
Solution Approach 1:
The imaging protocol is pre-configured with defined time intervals and phase parameters before patient scanning. The system automatically schedules and triggers successive CT angiogram phases at predetermined intervals (e.g., 0, 15, 30, 45 seconds), eliminating the need for manual timing and coordination during the scan. This preliminary setup reduces diagnostic time while managing complexity through automated protocol execution.
Solution Approach 2:
The system incorporates automatic feedback mechanisms where each completed phase provides contrast density data that informs the timing and parameters of subsequent phases. The imaging protocol adjusts based on real-time contrast bolus arrival and distribution patterns, optimizing the timing of each phase to capture critical information about arterial collaterals and penumbra perfusion without requiring complex manual intervention.
3Object-affected harmful factors
If traditional single-phase CT angiogram is used, then radiation exposure is minimized, but information about contrast density trends and collateral perfusion is insufficient
Solution Approach 1:
The diagnostic information is segmented across multiple time points rather than captured in a single phase. By dividing the contrast bolus passage into discrete phases at defined intervals, the system reconstructs contrast density trends and collateral perfusion dynamics from multiple low-dose measurements, achieving sufficient diagnostic information about arterial collaterals while keeping the radiation dose of each individual phase minimal.
Solution Approach 2:
The imaging protocol changes key parameters (time interval, phase timing, contrast injection rate) between successive scans to optimize information capture. Each phase is tailored to capture specific aspects of contrast flow and collateral perfusion at different temporal stages, allowing comprehensive assessment of contrast density trends and arterial collateral function while maintaining low radiation exposure through parameter optimization rather than increased dose.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
mCTA significantly reduces diagnostic time, provides more accurate and reproducible collateral maps, minimizes radiation exposure, and allows for consistent implementation across different treatment centers, enhancing the chances of saving penumbra tissue and improving treatment outcomes by enabling timely and informed decision-making.
Implementation Method 1
obtain a set of computed tomography (CT) images of the patient's brain
Data Source
AI summary
The invention relates to systems and methods for diagnosing strokes. In particular, systems and methods for acquiring timely patient status information are described that enable a physician to make diagnostic and treatment decisions relating to ischemic and hemorrhagic strokes. The systems and methods enable the efficient and quantitative assessment of arterial collaterals within the brain for aiding these decisions in the case of ischemic strokes. In the case of hemorrhagic strokes, the systems and methods are effective in determining if there is a leak and what is the rate of leaking.