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Andrée, Daniel; Thanabalasingam, Arjun; Teubner, Jonas; Fahrni, Markus; Potthast, Silke

Diagnostic Value of Computed Tomography Angiography in Suspected Acute Ischemic Stroke Patients With Respect to National Institutes of Health Stroke Scale Score

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  • Medientyp: E-Artikel
  • Titel: Diagnostic Value of Computed Tomography Angiography in Suspected Acute Ischemic Stroke Patients With Respect to National Institutes of Health Stroke Scale Score
  • Beteiligte: Andrée, Daniel; Thanabalasingam, Arjun; Teubner, Jonas; Fahrni, Markus; Potthast, Silke
  • Erschienen: Ovid Technologies (Wolters Kluwer Health), 2023
  • Erschienen in: Journal of Computer Assisted Tomography, 47 (2023) 4, Seite 666-670
  • Sprache: Englisch
  • DOI: 10.1097/rct.0000000000001458
  • ISSN: 1532-3145; 0363-8715
  • Schlagwörter: Radiology, Nuclear Medicine and imaging
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec> <jats:title>Objective</jats:title> <jats:p>Noncontrast computed tomography (NCCT) plus computed tomography angiography (CTA) is the standard imaging modality for acute stroke. We investigated whether there is an additional diagnostic value of supra-aortic CTA in relation to National Institutes of Health Stroke Scale (NIHSS) and resultant effective radiation dose.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>In this observational study, 788 patients with suspected acute stroke were included and divided into 3 NIHSS groups: group 1, NIHSS 0–2; group 2, NIHSS 3–5; and group 3, NIHSS ≥ 6.</jats:p> <jats:p>Computed tomography scans were assessed for findings of acute ischemic stroke and vascular pathologies in 3 regions. Final diagnosis was obtained from medical records. Effective radiation dose was calculated based on the dose-length product.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Seven hundred forty-one patients were included. Group 1 had 484 patients, group 2 had 127 patients, and group 3 had 130 patients. Computed tomography diagnosis of acute ischemic stroke was made in 76 patients. In 37 patients, a diagnosis of acute stroke was made based on pathologic CTA findings in case of an unremarkable NCCT. Stroke occurrence was the lowest in groups 1 and 2, with 3.6% and 6.3%, respectively, compared with 12.7% in group 3. If both NCCT and CTA were positive, the patient was discharged with a stroke diagnosis. Male sex had the highest effect on the final stroke diagnosis. The mean effective radiation dose was 2.6 mSv.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>In female patients with NIHSS 0–2, additional CTA rarely contains relevant additional findings decisive for treatment decisions or overall patient outcomes; therefore, CTA in this patient group might yield less impactful findings, and the applied radiation dose could be lowered by approximately 35%.</jats:p> </jats:sec>