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<meta name="DC.Title" content="Functional Contrast-Enhanced CT for Evaluation of Acute Ischemic Stroke Does Not Increase the Risk of Contrast-Induced Nephropathy" />
<meta name="DC.Identifier" content="10.3174/ajnr.A1927" />
<meta name="DC.Date" content="2010-05-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology. 
Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Concerns have recently grown regarding the safety of iodinated contrast agents used for CTA and CTP imaging. We tested whether the incidence of AN, defined by a ≥25% increase in the post−contrast scan creatinine level, was higher among patients with ischemic stroke who underwent a functional contrast-enhanced CT protocol compared with those who had no iodinated contrast administration.

MATERIALS AND METHODS: The contrast-exposed group consisted of 575 patients with acute ischemic stroke who underwent CTA ( n = 313), CTA/CTP ( n = 224), or CTA/CTP followed by conventional angiography ( n = 38) within 24 hours of stroke onset and were consecutively enrolled in a prospective cohort study. The nonexposed group consisted of 343 patients with ischemic stroke, consecutively admitted to the same institution, who did not receive iodinated contrast material. Patients were stratified by baseline eGFR. In the primary analysis, the Fisher exact test was used to compare the incidence of AN between the contrast-exposed and the nonexposed patients at 24, 48, and 72 hours and on a cumulative basis. A secondary analysis compared the incidence of AN in patients who underwent conventional angiography following CTA/CTP versus patients who underwent CTA/CTP only.

RESULTS: The incidence of AN was 5% in the exposed and 10% in the nonexposed group ( P = .003). Patients who underwent conventional angiography after contrast CT were at no greater risk of AN than patients who underwent CTA/CTP alone (26 patients, 5%; and 2 patients, 5%, respectively; P = .7).

CONCLUSIONS: Administration of a contrast-enhanced CT protocol involving CTA/CTP and conventional angiography in selected patients does not appear to increase the incidence of CIN.

AN
:   acute nephropathy
CIN
:   contrast-induced nephropathy
Cr
:   creatinine
CTA
:   CT angiography
CTP
:   CT perfusion
eGFR
:   estimated glomerular filtration rate
IQR
:   interquartile range
kV(p)
:   kilovolt (peak)
NIH
:   National Institutes of Health
STOP
:   Screening Technology and Outcomes Project in Stroke" />
<meta name="DC.Contributor" content="F.O. Lima" />
<meta name="DC.Contributor" content="M.H. Lev" />
<meta name="DC.Contributor" content="R.A. Levy" />
<meta name="DC.Contributor" content="G.S. Silva" />
<meta name="DC.Contributor" content="M. Ebril" />
<meta name="DC.Contributor" content="É.C. de Camargo" />
<meta name="DC.Contributor" content="S. Pomerantz" />
<meta name="DC.Contributor" content="A.B. Singhal" />
<meta name="DC.Contributor" content="D.M. Greer" />
<meta name="DC.Contributor" content="H. Ay" />
<meta name="DC.Contributor" content="R. Gilberto González" />
<meta name="DC.Contributor" content="W.J. Koroshetz" />
<meta name="DC.Contributor" content="W.S. Smith" />
<meta name="DC.Contributor" content="K.L. Furie" />
<meta name="article:published_time" content="2010-05-01" />
<meta name="article:section" content="Patient Safety" />
<meta name="citation_title" content="Functional Contrast-Enhanced CT for Evaluation of Acute Ischemic Stroke Does Not Increase the Risk of Contrast-Induced Nephropathy" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Concerns have recently grown regarding the safety of iodinated contrast agents used for CTA and CTP imaging. We tested whether the incidence of AN, defined by a ≥25% increase in the post−contrast scan creatinine level, was higher among patients with ischemic stroke who underwent a functional contrast-enhanced CT protocol compared with those who had no iodinated contrast administration.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;The contrast-exposed group consisted of 575 patients with acute ischemic stroke who underwent CTA (&lt;i&gt;n&lt;/i&gt; = 313), CTA/CTP (&lt;i&gt;n&lt;/i&gt; = 224), or CTA/CTP followed by conventional angiography (&lt;i&gt;n&lt;/i&gt; = 38) within 24 hours of stroke onset and were consecutively enrolled in a prospective cohort study. The nonexposed group consisted of 343 patients with ischemic stroke, consecutively admitted to the same institution, who did not receive iodinated contrast material. Patients were stratified by baseline eGFR. In the primary analysis, the Fisher exact test was used to compare the incidence of AN between the contrast-exposed and the nonexposed patients at 24, 48, and 72 hours and on a cumulative basis. A secondary analysis compared the incidence of AN in patients who underwent conventional angiography following CTA/CTP versus patients who underwent CTA/CTP only.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The incidence of AN was 5% in the exposed and 10% in the nonexposed group (&lt;i&gt;P&lt;/i&gt; = .003). Patients who underwent conventional angiography after contrast CT were at no greater risk of AN than patients who underwent CTA/CTP alone (26 patients, 5%; and 2 patients, 5%, respectively; &lt;i&gt;P&lt;/i&gt; = .7).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Administration of a contrast-enhanced CT protocol involving CTA/CTP and conventional angiography in selected patients does not appear to increase the incidence of CIN.&lt;/p&gt;" />
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<meta name="twitter:title" content="Functional Contrast-Enhanced CT for Evaluation of Acute Ischemic Stroke Does Not Increase the Risk of Contrast-Induced Nephropathy" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Concerns have recently grown regarding the safety of iodinated contrast agents used for CTA and CTP imaging. We tested whether the incidence of AN, defined by a ≥25% increase in the post−contrast scan creatinine level, was higher among patients with ischemic stroke who underwent a functional contrast-enhanced CT protocol compared with those who had no iodinated contrast administration.

MATERIALS AND METHODS: The contrast-exposed group consisted of 575 patients with acute ischemic stroke who underwent CTA ( n = 313), CTA/CTP ( n = 224), or CTA/CTP followed by conventional angiography ( n = 38) within 24 hours of stroke onset and were consecutively enrolled in a prospective cohort study. The nonexposed group consisted of 343 patients with ischemic stroke, consecutively admitted to the same institution, who did not receive iodinated contrast material. Patients were stratified by baseline eGFR. In the primary analysis, the Fisher exact test was used to compare the incidence of AN between the contrast-exposed and the nonexposed patients at 24, 48, and 72 hours and on a cumulative basis. A secondary analysis compared the incidence of AN in patients who underwent conventional angiography following CTA/CTP versus patients who underwent CTA/CTP only.

RESULTS: The incidence of AN was 5% in the exposed and 10% in the nonexposed group ( P = .003). Patients who underwent conventional angiography after contrast CT were at no greater risk of AN than patients who underwent CTA/CTP alone (26 patients, 5%; and 2 patients, 5%, respectively; P = .7).

CONCLUSIONS: Administration of a contrast-enhanced CT protocol involving CTA/CTP and conventional angiography in selected patients does not appear to increase the incidence of CIN.

AN
:   acute nephropathy
CIN
:   contrast-induced nephropathy
Cr
:   creatinine
CTA
:   CT angiography
CTP
:   CT perfusion
eGFR
:   estimated glomerular filtration rate
IQR
:   interquartile range
kV(p)
:   kilovolt (peak)
NIH
:   National Institutes of Health
STOP
:   Screening Technology and Outcomes Project in Stroke" />
<meta name="og-title" property="og:title" content="Functional Contrast-Enhanced CT for Evaluation of Acute Ischemic Stroke Does Not Increase the Risk of Contrast-Induced Nephropathy" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/5/817" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Concerns have recently grown regarding the safety of iodinated contrast agents used for CTA and CTP imaging. We tested whether the incidence of AN, defined by a ≥25% increase in the post−contrast scan creatinine level, was higher among patients with ischemic stroke who underwent a functional contrast-enhanced CT protocol compared with those who had no iodinated contrast administration.

MATERIALS AND METHODS: The contrast-exposed group consisted of 575 patients with acute ischemic stroke who underwent CTA ( n = 313), CTA/CTP ( n = 224), or CTA/CTP followed by conventional angiography ( n = 38) within 24 hours of stroke onset and were consecutively enrolled in a prospective cohort study. The nonexposed group consisted of 343 patients with ischemic stroke, consecutively admitted to the same institution, who did not receive iodinated contrast material. Patients were stratified by baseline eGFR. In the primary analysis, the Fisher exact test was used to compare the incidence of AN between the contrast-exposed and the nonexposed patients at 24, 48, and 72 hours and on a cumulative basis. A secondary analysis compared the incidence of AN in patients who underwent conventional angiography following CTA/CTP versus patients who underwent CTA/CTP only.

RESULTS: The incidence of AN was 5% in the exposed and 10% in the nonexposed group ( P = .003). Patients who underwent conventional angiography after contrast CT were at no greater risk of AN than patients who underwent CTA/CTP alone (26 patients, 5%; and 2 patients, 5%, respectively; P = .7).

CONCLUSIONS: Administration of a contrast-enhanced CT protocol involving CTA/CTP and conventional angiography in selected patients does not appear to increase the incidence of CIN.

AN
:   acute nephropathy
CIN
:   contrast-induced nephropathy
Cr
:   creatinine
CTA
:   CT angiography
CTP
:   CT perfusion
eGFR
:   estimated glomerular filtration rate
IQR
:   interquartile range
kV(p)
:   kilovolt (peak)
NIH
:   National Institutes of Health
STOP
:   Screening Technology and Outcomes Project in Stroke" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node9886--5" data-node-nid="9886" id="top-node-9886--6663741345" data-pisa="ajnr;31/5/817" data-pisa-master="ajnr;ajnr.A1927" data-apath="/ajnr/31/5/817.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Patient Safety</span></span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-series highwire-cite-metadata">E</span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Functional Contrast-Enhanced CT for Evaluation of Acute Ischemic Stroke Does Not Increase the Risk of Contrast-Induced Nephropathy</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">F.O. Lima</span>, <span class="highwire-citation-author" data-delta="1">M.H. Lev</span>, <span class="highwire-citation-author" data-delta="2">R.A. Levy</span>, <span class="highwire-citation-author" data-delta="3">G.S. Silva</span>, <span class="highwire-citation-author" data-delta="4">M. Ebril</span>, <span class="highwire-citation-author" data-delta="5">É.C. de Camargo</span>, <span class="highwire-citation-author" data-delta="6">S. Pomerantz</span>, <span class="highwire-citation-author" data-delta="7">A.B. Singhal</span>, <span class="highwire-citation-author" data-delta="8">D.M. Greer</span>, <span class="highwire-citation-author" data-delta="9">H. Ay</span>, <span class="highwire-citation-author" data-delta="10">R. Gilberto González</span>, <span class="highwire-citation-author" data-delta="11">W.J. Koroshetz</span>, <span class="highwire-citation-author" data-delta="12">W.S. Smith</span> and <span class="highwire-citation-author" data-delta="13">K.L. Furie</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2010,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">817-821; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A1927 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-9886--6663741345" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">F.O. Lima </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.O.%2BLima%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lima%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AF.O.%2BLima%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M.H. 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Silva </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.S.%2BSilva%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Silva%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AG.S.%2BSilva%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">M. 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Pomerantz </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BPomerantz%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pomerantz%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.%2BPomerantz%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">A.B. 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<p id="p-4"><strong>BACKGROUND AND PURPOSE:</strong> Concerns have recently grown regarding the safety of iodinated contrast agents used for CTA and CTP imaging. We tested whether the incidence of AN, defined by a ≥25% increase in the post−contrast scan creatinine level, was higher among patients with ischemic stroke who underwent a functional contrast-enhanced CT protocol compared with those who had no iodinated contrast administration.</p>
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<p id="p-5"><strong>MATERIALS AND METHODS:</strong> The contrast-exposed group consisted of 575 patients with acute ischemic stroke who underwent CTA (<em>n</em> = 313), CTA/CTP (<em>n</em> = 224), or CTA/CTP followed by conventional angiography (<em>n</em> = 38) within 24 hours of stroke onset and were consecutively enrolled in a prospective cohort study. The nonexposed group consisted of 343 patients with ischemic stroke, consecutively admitted to the same institution, who did not receive iodinated contrast material. Patients were stratified by baseline eGFR. In the primary analysis, the Fisher exact test was used to compare the incidence of AN between the contrast-exposed and the nonexposed patients at 24, 48, and 72 hours and on a cumulative basis. A secondary analysis compared the incidence of AN in patients who underwent conventional angiography following CTA/CTP versus patients who underwent CTA/CTP only.</p>
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<p id="p-6"><strong>RESULTS:</strong> The incidence of AN was 5% in the exposed and 10% in the nonexposed group (<em>P</em> = .003). Patients who underwent conventional angiography after contrast CT were at no greater risk of AN than patients who underwent CTA/CTP alone (26 patients, 5%; and 2 patients, 5%, respectively; <em>P</em> = .7).</p> 
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<p id="p-7"><strong>CONCLUSIONS:</strong> Administration of a contrast-enhanced CT protocol involving CTA/CTP and conventional angiography in selected patients does not appear to increase the incidence of CIN.</p>
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</div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">AN<span class="def-item-dt-sep"></span></dt><dd>acute nephropathy<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">CIN<span class="def-item-dt-sep"></span></dt><dd>contrast-induced nephropathy<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">Cr<span class="def-item-dt-sep"></span></dt><dd>creatinine<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">CTA<span class="def-item-dt-sep"></span></dt><dd>CT angiography<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">CTP<span class="def-item-dt-sep"></span></dt><dd>CT perfusion<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">eGFR<span class="def-item-dt-sep"></span></dt><dd>estimated glomerular filtration rate<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">IQR<span class="def-item-dt-sep"></span></dt><dd>interquartile range<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">kV(p)<span class="def-item-dt-sep"></span></dt><dd>kilovolt (peak)<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">NIH<span class="def-item-dt-sep"></span></dt><dd>National Institutes of Health<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">STOP<span class="def-item-dt-sep"></span></dt><dd>Screening Technology and Outcomes Project in Stroke</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-3">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/31/5/817.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Functional Contrast-Enhanced CT for Evaluation of Acute Ischemic Stroke Does Not Increase the Risk of Contrast-Induced Nephropathy</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">F.O.</span> <span class="nlm-surname">Lima</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.H.</span> <span class="nlm-surname">Lev</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">R.A.</span> <span class="nlm-surname">Levy</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">G.S.</span> <span class="nlm-surname">Silva</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Ebril</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">É.C.</span> <span class="nlm-surname">de Camargo</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Pomerantz</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">A.B.</span> <span class="nlm-surname">Singhal</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">D.M.</span> <span class="nlm-surname">Greer</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Ay</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">R. Gilberto</span> <span class="nlm-surname">González</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">W.J.</span> <span class="nlm-surname">Koroshetz</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">W.S.</span> <span class="nlm-surname">Smith</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">K.L.</span> <span class="nlm-surname">Furie</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">817-821; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A1927 </span></div>
  
  
  
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      <div class="highwire-cite-title">Functional Contrast-Enhanced CT for Evaluation of Acute Ischemic Stroke Does Not Increase the Risk of Contrast-Induced Nephropathy</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">F.O.</span> <span class="nlm-surname">Lima</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.H.</span> <span class="nlm-surname">Lev</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">R.A.</span> <span class="nlm-surname">Levy</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">G.S.</span> <span class="nlm-surname">Silva</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Ebril</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">É.C.</span> <span class="nlm-surname">de Camargo</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Pomerantz</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">A.B.</span> <span class="nlm-surname">Singhal</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">D.M.</span> <span class="nlm-surname">Greer</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Ay</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">R. Gilberto</span> <span class="nlm-surname">González</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">W.J.</span> <span class="nlm-surname">Koroshetz</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">W.S.</span> <span class="nlm-surname">Smith</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">K.L.</span> <span class="nlm-surname">Furie</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">817-821; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A1927 </span></div>
  
  
  
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