Table 1.

Summary of the various modalities used for thrombus imaging

Modality	Characteristics
Non-contrast CT	• Quickly performed
	• Hyperdense MCA sign identified
	• Hyperdense basilar artery sign identified
	• Density (in HU) can be determined
CT	• Uses thinner slices than noncontrast CT
	• Useful for vertebrobasilar system
	• Useful for internal carotid artery plaques
	• Accurately detects clot length
GRE MRI	• Helps to rule out hemorrhage and clearly identify occlusion
	• Low intensity vessel signs in proximal MCA
	• Blooming artifact identified
	• Location and content of clot can be determined
FLAIR MRI	• High intensity vessel signs
	• Distinguishes between proximal MCA vs distal
	• Discontinuity indicates thrombus
	• FVH most often in Sylvian fissure
MRA	• Useful for carotid bifurcation and intravascular thrombus
	• Better for identifying occlusions of Ml segment of MCA, not distal
	• Useful for clot location and burden, but not characteristics of clot composition
Catheter Angiography	• Helps determine internal carotid artery occlusions
	• Noninvasive (actually quite invasive) and sensitive
	• Offers “in-situ” treatment
	• Defines the location of proximal occlusions and corresponding collaterals
	• Helps determine the starting point of an occlusion
TCD	• Great bedside tool and continuous monitoring
	• Useful in patients undergoing thrombolysis
	• Can determine location of clot