Article Figures & Data
Figures
- FIGURE.
Examples of the multisegment clot sign on dynamic CT angiography derived from CT perfusion. A, One patient with LAA had 1 clot (black dot) presenting as 1 segment in the middle cerebral artery, which was categorized as a 1-segment clot. B, One patient with CE had 2 segments of the clot on a delayed phase of dynamic CTA, which was categorized as a multisegment clot. C, Another patient with CE had 2 segments of the clot on a late delayed phase of dynamic CTA, which was also categorized as a multisegment clot.
Tables
- Table 1:
Comparison of baseline characteristics between patients with and without the MSC signa
No MSC (n = 120) MSC (n = 74) P Value Age (yr) 70 (60–79) 76 (63–80) .097 Male sex (No.) (%) 71 (59.2%) 41 (55.4%) .606 Baseline NIHSS score 13 (7–16) 13 (9–17) .217 Systolic BP (mm Hg) 149 (133–162) 150 (137–169) .288 Diastolic BP (mm Hg) 80 (71–90) 79 (71–94) .975 Onset-to-imaging time (min) 185 (115–236) 152 (92–223) .105 Laboratory data Glucose (mg/dL) 7.10 (6.28–8.30) 6.60 (5.78–7.36) .017 Leukocytes (10E9/L) 8.30 (6.60–10.53) 7.10 (5.75–9.25) .028 Percentage of neutrophils 75.75 (64.63–83.40) 74.70 (61.50–84.65) .874 Platelets (10E9/L) 183 (145–216) 171 (130–209) .305 Risk factors Smoking (No.) (%) 42 (35.0%) 23 (31.1%) .574 Hypertension (No.) (%) 73 (60.8%) 52 (70.3%) .182 Diabetes mellitus (No.) (%) 27 (22.5%) 9 (12.2%) .072 Hyperlipidemia (No.) (%) 46 (38.3%) 27 (36.5%) .796 History of stroke/TIA (No.) (%) 21 (17.5%) 11 (14.9%) .631 Atrial fibrillation (No.) (%) 53 (44.2%) 56 (75.7%) <.001 Prior antiplatelet use (No.) (%) 19 (15.8%) 14 (18.9%) .578 Prior Coumadin use (No.) (%) 4 (3.3%) 6 (8.1%) .260 Stroke etiologies CE (No.) (%) 52 (43.3%) 58 (78.4%) <.001 LAA (No.) (%) 39 (32.5%) 4 (5.4%) <.001 Undetermined etiology (No.) (%) 29 (24.2%) 12 (16.2%) .188 Note:—BP indicates blood pressure.
↵a Data are expressed as median (Q1–Q3) for continuous variables.
CE (n = 110) LAA (n = 43) Undetermined Etiology (n = 41) Pa Pb Age (yr) 74 (66–80) 67 (56–79) 63 (59–79) .016 .016 Male sex (No.) (%) 52 (47.3%) 32 (74.4%) 28 (68.3%) .003 .002 Baseline NIHSS score 14 (10–18) 10 (5–14) 14 (9–18) .002 .001 Systolic BP (mm Hg) 150 (133–168) 154 (138–164) 144 (129–155) .172 .450 Diastolic BP (mm Hg) 79 (71–94) 80 (72–93) 78 (68–89) .370 .955 Onset-to-imaging time (min) 154 (92–225) 163 (112–230) 197 (134–262) .128 .540 Prior antiplatelet use (No.) (%) 19 (17.3%) 6 (14.0%) 8 (19.5%) .790 .618 Risk factors Smoking (No.) (%) 28 (25.5%) 21 (48.8%) 16 (39.0%) .016 .005 Hypertension (No.) (%) 73 (66.4%) 29 (67.4%) 23 (56.1%) .451 .899 Diabetes mellitus (No.) (%) 20 (18.2%) 11 (25.6%) 5 (12.2%) .285 .306 Hyperlipidemia (No.) (%) 41 (37.3%) 15 (34.9%) 17 (41.5%) .818 .783 History of stroke/TIA (No.) (%) 19 (17.3%) 9 (20.9%) 4 (9.8%) .365 .599 Atrial fibrillation (No.) (%) 98 (89.1%) 0 (0.0%) 11 (26.8%) <.001 <.001 MSC sign (No.) (%) 58 (52.7%) 4 (9.3%) 12 (29.3%) <.001 <.001 Variables PR (95% CI) P Value Age 1.01 (0.99–1.02) .453 Baseline NIHSS score 1.02 (0.99–1.05) .195 Male 0.86 (0.53–1.40) .552 Smoking 0.83 (0.48–1.43) .499 Systolic BP 1.00 (0.99–1.01) .550 Onset-to-imaging time 1.00 (1.00–1.00) .984 MSC sign 1.53 (1.03–2.90) .037 Note:—PR indicates prevalence ratio; BP, blood pressure.
Variables PR (95% CI) P Values Age 1.00 (0.99–1.02) .602 Baseline NIHSS score 1.00 (0.97–1.04) .784 Male sex 0.84 (0.53–1.34) .472 Smoking 0.94 (0.55–1.60) .818 Systolic BP 1.00 (1.00–1.00) .776 Onset-to-imaging time 1.00 (1.00–1.00) .373 MSC sign 1.19 (0.80–1.76) .393 Note:—PR indicates prevalence ratio; BP, blood pressure.
- Table 5:
Diagnostic testing of the multisegment clot sign for predicting cardioembolism with or without excluding patients with undetermined etiology
Sensitivity (%) Specificity (%) Positive Predictive Value (%) Negative Predictive Value (%) Accuracy All patients (n = 194) 52.7 81.0 78.4 56.7 64.9 Excluding UE (n = 153) 52.7 90.7 93.5 42.9 63.4 Note:—UE indicates undetermined etiology.
