Evidence map›Paper›PMID 42814121›Full record

ArticleEuropean radiology2026

Quantitative assessment of cerebral venous outflow on routine CT angiography in acute ischemic stroke.

Tobias D Faizy, Henk van Voorst, Gregory W Albers, Vivek Yedavalli, Dhairya A Lakhani, Maarten G Lansberg, Helge Kniep, Christian Heitkamp, Alexander Heitkamp, Paul Christian Stracke and 6 more

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Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

16 authors.

Tobias D FaizyDivision of Interventional Neuroradiology, Department of Radiology, University Hospital Münster, Münster, Germany. Tobias.Faizy@ukmuenster.de.ORCID http://orcid.org/0000-0002-1631-2020
Henk van VoorstDepartment of Radiology, Stanford University School of Medicine, Stanford, CA, USA.
Gregory W AlbersDepartment of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Vivek YedavalliDepartment of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Dhairya A LakhaniDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.
Maarten G LansbergDepartment of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Helge KniepDepartment of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg-Nord, Germany.
Christian HeitkampDepartment of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg-Nord, Germany.
Alexander HeitkampDepartment of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg-Nord, Germany.
Paul Christian StrackeDivision of Interventional Neuroradiology, Department of Radiology, University Hospital Münster, Münster, Germany.
Hermann KrählingDivision of Interventional Neuroradiology, Department of Radiology, University Hospital Münster, Münster, Germany.
René WernerImage Processing and Medical Imaging, Institute for Applied Medical Informatics, Institute for Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Gabriel BroocksDepartment of Neuroradiology, HELIOS Medical Center, University Campus of MSH Medical School Hamburg, Schwerin, Germany.
Jens FiehlerDepartment of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg-Nord, Germany.
Max WintermarkDepartment of Radiology, The University of Texas Medical Branch, Houston-Galveston, TX, USA.
Jeremy J HeitDepartment of Radiology, Stanford University School of Medicine, Stanford, CA, USA.

Funding

Else Kröner-Fresenius-Stiftung 2023_EKES.02).
6 · The paper itself

Abstract

objectivesTo develop and validate a semi-automated, observer-independent method for quantitative assessment of cerebral venous outflow on routine single-phase CT angiography (CTA) in acute ischemic stroke. MATERIALS AND

methodsIn this multicenter retrospective study, patients with anterior circulation large-vessel occlusion who underwent baseline CTA were included. Venous attenuation was quantified in predefined cortical and deep venous structures using centerline-based segmentations and automated extraction of intraluminal Hounsfield units. Quantitative measures were compared with established visual venous outflow scores using Spearman correlation. Receiver operating characteristic (ROC) analyses assessed discrimination of visually defined opacification categories.

resultsA total of 242 patients were analyzed (median age 75 years; median NIHSS 14.5). Quantitative venous attenuation showed strong correlations with visual venous scores at the segment level for cortical veins (ρ = 0.72-0.77; all p < 0.001). Correlations for deep venous structures were moderate overall but increased substantially in proximal occlusions. Composite quantitative metrics demonstrated moderate correlations with corresponding visual scores (ρ = 0.62-0.64; p < 0.001). ROC analyses showed high discrimination of venous opacification states at the segment level (AUC 0.81-0.95; 95% CI 0.74-0.97). Quantitative attenuation values remained measurable in visually non-opacified segments, indicating additional continuous information beyond ordinal grading. Results were consistent across centers and robust to arterial normalization.

conclusionQuantitative venous attenuation derived from routine CTA enables reproducible, observer-independent assessment of cerebral venous outflow, closely reflecting established visual scoring while providing additional continuous information. This approach represents a scalable imaging biomarker with direct applicability to routine stroke imaging workflows. KEY POINTS: Question Visual assessment of cerebral venous outflow is observer-dependent and limited to ordinal grading. Findings Quantitative venous attenuation derived from routine CT angiography closely reflects established visual venous outflow scores at the segment level. Clinical relevance Quantitative assessment of venous outflow from routine CT angiography is feasible and scalable, with direct applicability to clinical stroke imaging workflows.

Indexed as

Cerebrovascular circulationCollateral circulationComputed tomography angiographyDiagnostic imagingIschemic stroke

Identifiers

PMID42814121

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.