{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T19:29:23Z","timestamp":1787945363549,"version":"build-2784847793"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>To differentiate between pseudo occlusion (PO) and true occlusion (TO) of internal carotid artery (ICA) is important in thrombectomy treatment planning for patients with acute ischemic stroke. Although delayed contrast filling has been differentiated carotid PO from TO, its application has been limited by the implementations of multiphasic computed tomography angiography. In this study, we hypothesized that carotid ring sign, which is readily acquired from single-phasic CTA, can sufficiently differentiate carotid TO from PO.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>One thousand four hundred and twenty patients with anterior circulation stroke receiving endovascular therapy were consecutively recruited through a hospital- and web-based registry. Two hundred patients with nonvisualization of the proximal ICA were included in the analysis after a retrospective screening. Diagnosis of PO or TO of the cervical segment of ICA was made based on digital subtraction angiography. Diagnostic performances of carotid ring sign on arterial-phasic CTA and delayed contrast filling on multiphasic computed tomography angiography were evaluated and compared.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              One-hundred twelve patients had ICA PO and 88 had TO. Carotid ring sign was more common in patients with TO (70.5% versus 6.3%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), whereas delayed contrast filling was more common in PO (94.9% versus 7.7%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). The sensitivity and specificity of carotid ring sign in diagnosing carotid TO were 0.70 and 0.94, respectively, whereas sensitivity and specificity of delayed contrast filling was 0.95 and 0.92 in judging carotid PO.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Carotid ring sign is a potent imaging marker in diagnosing ICA TO. Carotid ring sign could be complementary to delayed contrast filling sign in differentiating TO from PO, in particular in centers with only single-phasic CTA.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.123.045156","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T18:01:02Z","timestamp":1711389662000},"page":"1025-1031","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Diagnostic Performance of Carotid Ring Sign on CT-Angiography in Internal Carotid True Occlusion"],"prefix":"10.1161","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3110-5844","authenticated-orcid":true,"given":"Tingyu","family":"Yi","sequence":"first","affiliation":[{"name":"Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)."},{"name":"Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (T.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2898-7877","authenticated-orcid":true,"given":"Yi","family":"Sui","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shenyang First People\u2019s Hospital, Shenyang Medical College, China (Y.S.)."},{"name":"Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China (Y.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1024-2049","authenticated-orcid":true,"given":"Dinghuan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Huian County Hospital, Quanzhou, Fujian, China (D.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5235-894X","authenticated-orcid":true,"given":"Xinwen","family":"Ren","sequence":"additional","affiliation":[{"name":"George Institute for Global Health China (X.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6222-303X","authenticated-orcid":true,"given":"Xiaohui","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanmin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinglai","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhinan","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5991-1453","authenticated-orcid":true,"given":"Xiufen","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5201-8232","authenticated-orcid":true,"given":"Ganji","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7466-2061","authenticated-orcid":true,"given":"Meihua","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisan","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhuo","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)."},{"name":"Department of Neurology, Fujian Medical University Union Hospital, China (W.C.)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"1","article-title":"Cervical internal carotid occlusion versus pseudo-occlusion at cT angiography in the context of acute stroke: an accuracy, interobserver, and intraobserver agreement study.","volume":"000","author":"Diouf A","year":"2018","unstructured":"Diouf, A, Fahed, R, Guilbert, F, Landry, D, Raymond, J, Roy, D. Cervical internal carotid occlusion versus pseudo-occlusion at cT angiography in the context of acute stroke: an accuracy, interobserver, and intraobserver agreement study. Radiology. 2018;000:1\u20138.","journal-title":"Radiology"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.015427"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.15142256"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.011401"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2013-010769"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2016.01522"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A6889"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.029512"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A6376"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-011-0868-9"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.4103\/2452-2473.357348"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2014.02.013"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.1106358"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/312764"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.113.002400"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.018264"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.a6582"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2017-013708"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.123.045156","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T15:05:04Z","timestamp":1726844704000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.123.045156"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1161\/STROKEAHA.123.045156"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.123.045156","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2023-09-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-11","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}