Dense artery sign on CT for stroke

A recently published study in Stroke found that a dense artery sign on non contrast CT head is approximately 50% sensitive and 95% specific for ischaemic stroke. The dense artery sign is when you see a hyperdense segment of a cerebral artery on a non contrast CT (they are not normally visible), indicating thrombus or embolus in the segment. It is most commonly seen in the MCA.

Here is an example of an M2 dense MCA sign. The increased area of attenuation in the anterior part of the midline  is incidental falcine calcification.

Dense L MCA sign M2













The reference is: Grant Mair, Elena V. Boyd, Francesca M. Chappell, Rüdiger von Kummer, Richard I. Lindley, Peter Sandercock, Joanna M. Wardlaw, IST-3 Collaborative Group. Sensitivity and Specificity of the Hyperdense Artery Sign for Arterial Obstruction in Acute Ischemic Stroke. Stroke. 2015;46:102-107. Originally published December 4, 2014. doi: 10.1161/STROKEAHA.114.007036

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