Imaging in Acute Ischemic Stroke



Date & Location
Monday, July 22, 2024, 12:00 PM - Tuesday, December 31, 2024, 11:59 PM

Target Audience
Specialties - Abdominal Radiology, Addiction Psychiatry, Adolescent Medicine, Advanced Heart Failure and Transplant Cardiology, Advanced Practice Professionals, Allergy and Immunology, Anesthesiology, Biochemical Genetics , Blood Banking - Transfusion Medicine, Cardiology, Cardiothoracic Radiology, Cardiothoracic Radiology, Cardiovascular Disease , Chemical Pathology , Child Abuse Pediatrics , Child and Adolescent Psychiatry, Child Neurology , Clinical and Laboratory Immunology, Clinical Cardiac Electrophysiology, Clinical Neurophysiology , Colon and Rectal Surgery, Congenital Cardiac Surgery, Counseling, Craniofacial Surgery , Critical Care Medicine, Cytopathology , Data Management and Informatics, Dental, Dermatology, Dermatopathology, Developmental-Behavioral Pediatrics, Emergency Medicine, Endocrinology, Diabetes and Metabolism , Endovascular Surgical Neuroradiology , Family Medicine, Foot and Ankle Orthopaedics, Forensic Pathology, Forensic Psychiatry , Gastroenterology, Geriatric Medicine , Geriatric Psychiatry, Hand Surgery , Hematology, Hematology and Oncology, Hospice and Palliative Care, Hospitalist, Infectious Disease, Internal Medicine, Internal Medicine-Pediatrics, Interventional Cardiology, Licensed Clinical Social Work, Marriage and Family Therapy, Medical Genetics, Medical Microbiology, Medical Toxicology, Molecular Genetic Pathology, Muscoskeletal Radiology, Musculoskeletal Oncology, Neonatal-Perinatal Medicine, Nephrology, Neurological Surgery, Neurology, Neuromuscular Medicine, Neuropathology, Neuroradiology , New Specialty, Nuclear Medicine, Nuclear Radiology, Nursing, Obstetric Anesthesiology, Obstetrics and Gynecology, Oncology, Ophthalmic Plastic and Reconstructive Surgery , Ophthalmology, Optometry, Orthopaedic Sports Medicine, Orthopaedic Surgery of the Spine, Orthopaedic Trauma, Orthopedic Surgery, Other, Otolaryngology, Otology - Neurotology, Pain Medicine, Paramedics/EMT, Pastoral Care, Pathology-Anatomic and Clinical, Patient Safety and Quality, Pediatric Anesthesiology, Pediatric Cardiology , Pediatric Critical Care Medicine, Pediatric Emergency Medicine, Pediatric Endocrinology , Pediatric Gastroenterology, Pediatric Hematology-Oncology, Pediatric Infectious Diseases, Pediatric Nephrology, Pediatric Orthopaedics, Pediatric Otolaryngology, Pediatric Pathology , Pediatric Pulmonology, Pediatric Radiology , Pediatric Rheumatology , Pediatric Sports Medicine, Pediatric Surgery , Pediatric Transplant Hepatology, Pediatric Urology, Pediatrics, Performance Improvement, Pharmacy, Physical Medicine and Rehabilitation, Physical Therapy, Plastic Surgery, Preventive Medicine, Primary Care, Psychiatry, Psychology, Public Health, Pulmonary Disease, Radiation Oncology, Radiology Diagnostic, Research, Respiratory Therapy, Rheumatology, Sleep Medicine, Social Work, Spinal Cord Injury Medicine, Sports Medicine, Surgery General, Surgical Critical Care , Thoracic Surgery, Thoracic Surgery-Integrated, Transplant Hepatology , Urology, Vascular and Interventional Radiology, Vascular Surgery

Overview

Ongoing series to similar audience presenting a rotating variety of topics in a lunch & learn format (anywhere from 20-120 minute sessions).

Launch Date:  7/22/2024

Expiration Date:  7/21/2025


Objectives
At the conclusion of this activity, participants should be able to:

  1. Identify clinical situations in which CTA head and neck is useful, necessary, and unnecessary
  2. Manually calculate an ASPECT score from a non-contrasted head CT
  3. Indicate the two clinical decisions that are made using information from CT Perfusion
  4. Discuss the value of MRI in the management of patients with acute ischemic stroke

Registration

How to obtain CE Credit:


Please note, you have to watch the entire video in order to receive any CE credit for this online activity.

Click the Tests tile > Launch Video to view the module (create an IUH account if you don't already have one).

Credit will be awarded 30 days post completion.


Accreditation
 
In support of improving patient care, this activity has been planned and implemented by Indiana University School of Medicine and IU Health. Indiana University School of Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


Physicians
Indiana University School of Medicine designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

References:

Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score. Lancet. 2000 May 13;355(9216):1670-4. doi: 10.1016/s0140-6736(00)02237-6. Erratum in: Lancet 2000 Jun 17;355(9221):2170. PMID: 10905241.

Shah VS, Eaton RG, Cua S, Dornbos D 3rd, Hoang N, Schunemann V, Nimjee S, Youssef P, Powers CJ. Scoring of Middle Cerebral Artery Collaterals Predicts RAPID CT-Perfusion Analysis and Short-Term Outcomes in Acute Ischemic Stroke Patients Undergoing Thrombectomy. World Neurosurg. 2020 Mar;135:e494-e499. doi: 10.1016/j.wneu.2019.12.033. Epub 2019 Dec 13. PMID: 31843729.

Harrar DB, Benedetti GM, Jayakar A, Carpenter JL, Mangum TK, Chung M, Appavu B; International Pediatric Stroke Study Group and Pediatric Neurocritical Care Research Group. Pediatric Acute Stroke Protocols in the United States and Canada. J Pediatr. 2022 Mar;242:220-227.e7. doi: 10.1016/j.jpeds.2021.10.048. Epub 2021 Nov 11. PMID: 34774972.

Mangla R, Ekhom S, Jahromi BS, Almast J, Mangla M, Westesson PL. CT perfusion in acute stroke: know the mimics, potential pitfalls, artifacts, and technical errors. Emerg Radiol. 2014 Feb;21(1):49-65. doi: 10.1007/s10140-013-1125-9. Epub 2013 Jun 15. PMID: 23771605.

Abrams K, Dabus G. Perfusion Scotoma: A Potential Core Underestimation in CT Perfusion in the Delayed Time Window in Patients with Acute Ischemic Stroke. AJNR Am J Neuroradiol. 2022 Jun;43(6):813-816. doi: 10.3174/ajnr.A7524. Epub 2022 May 26. PMID: 35618426; PMCID: PMC9172961.

Vagal A, Wintermark M, Nael K, Bivard A, Parsons M, Grossman AW, Khatri P. Automated CT perfusion imaging for acute ischemic stroke: Pearls and pitfalls for real-world use. Neurology. 2019 Nov 12;93(20):888-898. doi: 10.1212/WNL.0000000000008481. Epub 2019 Oct 21. PMID: 31636160.

Huo X, Ma G, Tong X, Zhang X, Pan Y, Nguyen TN, Yuan G, Han H, Chen W, Wei M, Zhang J, Zhou Z, Yao X, Wang G, Song W, Cai X, Nan G, Li D, Wang AY, Ling W, Cai C, Wen C, Wang E, Zhang L, Jiang C, Liu Y, Liao G, Chen X, Li T, Liu S, Li J, Gao F, Ma N, Mo D, Song L, Sun X, Li X, Deng Y, Luo G, Lv M, He H, Liu A, Zhang J, Mu S, Liu L, Jing J, Nie X, Ding Z, Du W, Zhao X, Yang P, Liu L, Wang Y, Liebeskind DS, Pereira VM, Ren Z, Wang Y, Miao Z; ANGEL-ASPECT Investigators. Trial of Endovascular Therapy for Acute Ischemic Stroke with Large Infarct. N Engl J Med. 2023 Apr 6;388(14):1272-1283. doi: 10.1056/NEJMoa2213379. Epub 2023 Feb 10. PMID: 36762852.

Sarraj A, Hassan AE, Abraham MG, Ortega-Gutierrez S, Kasner SE, Hussain MS, Chen M, Blackburn S, Sitton CW, Churilov L, Sundararajan S, Hu YC, Herial NA, Jabbour P, Gibson D, Wallace AN, Arenillas JF, Tsai JP, Budzik RF, Hicks WJ, Kozak O, Yan B, Cordato DJ, Manning NW, Parsons MW, Hanel RA, Aghaebrahim AN, Wu TY, Cardona-Portela P, Pérez de la Ossa N, Schaafsma JD, Blasco J, Sangha N, Warach S, Gandhi CD, Kleinig TJ, Sahlein D, Elijovich L, Tekle W, Samaniego EA, Maali L, Abdulrazzak MA, Psychogios MN, Shuaib A, Pujara DK, Shaker F, Johns H, Sharma G, Yogendrakumar V, Ng FC, Rahbar MH, Cai C, Lavori P, Hamilton S, Nguyen T, Fifi JT, Davis S, Wechsler L, Pereira VM, Lansberg MG, Hill MD, Grotta JC, Ribo M, Campbell BC, Albers GW; SELECT2 Investigators. Trial of Endovascular Thrombectomy for Large Ischemic Strokes. N Engl J Med. 2023 Apr 6;388(14):1259-1271. doi: 10.1056/NEJMoa2214403. Epub 2023 Feb 10. Erratum in: N Engl J Med. 2024 Jan 25;390(4):388. doi: 10.1056/NEJMx230009. PMID: 36762865.

Yoshimura S, Sakai N, Yamagami H, Uchida K, Beppu M, Toyoda K, Matsumaru Y, Matsumoto Y, Kimura K, Takeuchi M, Yazawa Y, Kimura N, Shigeta K, Imamura H, Suzuki I, Enomoto Y, Tokunaga S, Morita K, Sakakibara F, Kinjo N, Saito T, Ishikura R, Inoue M, Morimoto T. Endovascular Therapy for Acute Stroke with a Large Ischemic Region. N Engl J Med. 2022 Apr 7;386(14):1303-1313. doi: 10.1056/NEJMoa2118191. Epub 2022 Feb 9. PMID: 35138767.

Albers GW, Marks MP, Kemp S, Christensen S, Tsai JP, Ortega-Gutierrez S, McTaggart RA, Torbey MT, Kim-Tenser M, Leslie-Mazwi T, Sarraj A, Kasner SE, Ansari SA, Yeatts SD, Hamilton S, Mlynash M, Heit JJ, Zaharchuk G, Kim S, Carrozzella J, Palesch YY, Demchuk AM, Bammer R, Lavori PW, Broderick JP, Lansberg MG; DEFUSE 3 Investigators. Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. N Engl J Med. 2018 Feb 22;378(8):708-718. doi: 10.1056/NEJMoa1713973. Epub 2018 Jan 24. PMID: 29364767; PMCID: PMC6590673.

Nogueira RG, Jadhav AP, Haussen DC, Bonafe A, Budzik RF, Bhuva P, Yavagal DR, Ribo M, Cognard C, Hanel RA, Sila CA, Hassan AE, Millan M, Levy EI, Mitchell P, Chen M, English JD, Shah QA, Silver FL, Pereira VM, Mehta BP, Baxter BW, Abraham MG, Cardona P, Veznedaroglu E, Hellinger FR, Feng L, Kirmani JF, Lopes DK, Jankowitz BT, Frankel MR, Costalat V, Vora NA, Yoo AJ, Malik AM, Furlan AJ, Rubiera M, Aghaebrahim A, Olivot JM, Tekle WG, Shields R, Graves T, Lewis RJ, Smith WS, Liebeskind DS, Saver JL, Jovin TG; DAWN Trial Investigators. Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct. N Engl J Med. 2018 Jan 4;378(1):11-21. doi: 10.1056/NEJMoa1706442. Epub 2017 Nov 11. PMID: 29129157.

Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, Biller J, Brown M, Demaerschalk BM, Hoh B, Jauch EC, Kidwell CS, Leslie-Mazwi TM, Ovbiagele B, Scott PA, Sheth KN, Southerland AM, Summers DV, Tirschwell DL. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2019 Dec;50(12):e344-e418. doi: 10.1161/STR.0000000000000211. Epub 2019 Oct 30. Erratum in: Stroke. 2019 Dec;50(12):e440-e441. doi: 10.1161/STR.0000000000000215. PMID: 31662037.


Additional Information

For questions about accessibility or to request accommodations please contact the IUSM CME office at 317-274-0104 or [email protected]. One week advance notice will allow us to provide seamless access. Please ensure to specify the accommodations you need in order to participate.


Credits
AMA PRA Category 1 Credits™ (1.00 hours), ABS CC (1.00 hours), Non-Physician Attendance (1.00 hours)