Comparison of two imaging protocols for acute stroke: Unenhanced cranial CT versus a multimodality cranial CT protocol with perfusion imaging

Authors: Langer; Neidl van Gorkom,; Al Kaabi,; Torab; Czechowski; Nagi; Ashish

Source: Australasian Radiology, Volume 51, Number 6, December 2007 , pp. 532-537(6)

Publisher: Wiley-Blackwell

Abstract:

Summary

The aim of the study was to validate a multimodality cranial computed tomography (CCT) protocol for patients with acute stroke in the United Arab Emirates as a basic imaging procedure for a stroke unit. Therefore, a comparative study was conducted between two groups: retrospective, historical group 1 with early unenhanced CCT and prospective group 2 undergoing a multimodality CCT protocol. Follow-up unenhanced CCT >48 h served as gold standard in both groups. Group 1: Early unenhanced CCT of 50 patients were evaluated retrospectively, using Alberta Stroke Program Early CT Score, and compared with the definite infarction on follow-up CCT. Group 2: 50 patients underwent multimodality CCT (unenhanced CCT, perfusion studies: cerebral blood flow, cerebral blood volume, mean transit time and CT angiography) <8 h after clinical onset and follow-up studies. Modified National Institute of Health Stroke Scale was used clinically in both groups. Group 1 showed 38 men, 12 women, clinical onset 2-8 h before CCT and modified National Institute of Health Stroke Scale 0-28. Group 2 included 38 men, 12 women, onset 3-8 h before CCT, modified National Institute of Health Stroke Scale 0-28. Sensitivity was 58.3% in group 1 and 84.2% in group 2. Computed tomography angiography detected nine intracranial occlusions/stenoses. The higher sensitivity of the multimodality CCT protocol justifies its use as a basic diagnostic tool for the set-up of a first-stroke unit in the United Arab Emirates.

Keywords: acute stroke; computed tomography angiography; cranial computed tomography; perfusion cranial computed tomography

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1440-1673.2007.01901.x

Publication date: 2007-12-01

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