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Reply: (including pial vessels), enabling faster detection of intracranial arterial occlusions. e thank Drs Singh, Zerna, and Menon for their interest in Wour study, and we are grateful for the opportunity to ad- REFERENCES dress their comments. First, we would like to acknowledge the 1. Byrne D, Sugrue G, Stanley E, et al. Improved detection of anterior circulation occlusions: the “delayed vessel sign” on multiphase CT utility and value of multiphase CT angiography as a development angiography. AJNR Am J Neuroradiol 2017;38:1911–16 CrossRef in the assessment of acute stroke, first described by the Calgary Medline Stroke Program. It is a dynamic, versatile, and multipurpose 2. Menon BK, d’Esterre CD, Qazi EM, et al. Multiphase CT angiography: tool, with benefit in the detection of distal intracranial arterial a new tool for the imaging triage of patients with acute ischemic occlusions as previously described by Yu et al. The purpose of our stroke. Radiology 2015;275:510–20 CrossRef Medline 3. Yu AY, Zerna C, Assis Z, et al. Multiphase CT angiography increases study was to demonstrate the effectiveness of an easily communi- detection of anterior circulation intracranial occlusion. Neurology cated imaging sign on multiphase CTA, “the delayed vessel sign,” 2016;87:609–16 CrossRef Medline which we have found to be intuitively understood even by junior 4. Byrne D, Walsh JP, Sugrue G, et al. Subtraction multiphase CT trainees. It is a reliable indicator of an intracranial arterial occlu- angiography: a new technique for faster detection of intracranial ar- terial occlusions. Eur Radiol 2017 Nov 13. [Epub ahead of print] sion, providing a rapid method to identify the precise site of oc- CrossRef Medline clusion. The sign is distinct from “asymmetric pial enhance- X D. Byrne ment,” which we separately evaluated in our article; in clinical X J.P. Walsh practice, we have found it to be a subtler imaging feature, espe- Department of Radiology Mater Misericordiae University Hospital cially when associated with distal vessel occlusions. We have re- Dublin, Ireland cently developed a new postprocessing technique “subtraction X P.J. MacMahon multiphase CT angiography,” which increases the conspicuity of Department of Radiology Mater Misericordiae University Hospital the delayed vessel sign by suppressing normally enhancing vessels Dublin, Ireland School of Medicine University College Dublin http://dx.doi.org/10.3174/ajnr.A5536 Dublin, Ireland E48 Letters Apr 2018 www.ajnr.org http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

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Publisher
American Journal of Neuroradiology
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A5536
Publisher site
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Abstract

(including pial vessels), enabling faster detection of intracranial arterial occlusions. e thank Drs Singh, Zerna, and Menon for their interest in Wour study, and we are grateful for the opportunity to ad- REFERENCES dress their comments. First, we would like to acknowledge the 1. Byrne D, Sugrue G, Stanley E, et al. Improved detection of anterior circulation occlusions: the “delayed vessel sign” on multiphase CT utility and value of multiphase CT angiography as a development angiography. AJNR Am J Neuroradiol 2017;38:1911–16 CrossRef in the assessment of acute stroke, first described by the Calgary Medline Stroke Program. It is a dynamic, versatile, and multipurpose 2. Menon BK, d’Esterre CD, Qazi EM, et al. Multiphase CT angiography: tool, with benefit in the detection of distal intracranial arterial a new tool for the imaging triage of patients with acute ischemic occlusions as previously described by Yu et al. The purpose of our stroke. Radiology 2015;275:510–20 CrossRef Medline 3. Yu AY, Zerna C, Assis Z, et al. Multiphase CT angiography increases study was to demonstrate the effectiveness of an easily communi- detection of anterior circulation intracranial occlusion. Neurology cated imaging sign on multiphase CTA, “the delayed vessel sign,” 2016;87:609–16 CrossRef Medline which we have found to be intuitively understood even by junior 4. Byrne D, Walsh JP, Sugrue G, et al. Subtraction multiphase CT trainees. It is a reliable indicator of an intracranial arterial occlu- angiography: a new technique for faster detection of intracranial ar- terial occlusions. Eur Radiol 2017 Nov 13. [Epub ahead of print] sion, providing a rapid method to identify the precise site of oc- CrossRef Medline clusion. The sign is distinct from “asymmetric pial enhance- X D. Byrne ment,” which we separately evaluated in our article; in clinical X J.P. Walsh practice, we have found it to be a subtler imaging feature, espe- Department of Radiology Mater Misericordiae University Hospital cially when associated with distal vessel occlusions. We have re- Dublin, Ireland cently developed a new postprocessing technique “subtraction X P.J. MacMahon multiphase CT angiography,” which increases the conspicuity of Department of Radiology Mater Misericordiae University Hospital the delayed vessel sign by suppressing normally enhancing vessels Dublin, Ireland School of Medicine University College Dublin http://dx.doi.org/10.3174/ajnr.A5536 Dublin, Ireland E48 Letters Apr 2018 www.ajnr.org

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Apr 1, 2018

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