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Irish Journal of Medical Science (1971 -)

Erschienen in:

24.08.2018 | Original Article

CT cervico-cerebral angiography in acute stroke. Can we justify aortic arch imaging?

verfasst von: Gavin Sugrue, Michael K. O’Reilly, Danielle Byrne, Matthew T. Crockett, Sean Murphy, Eoin C. Kavanagh

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 2/2019

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Abstract

Objectives

Computed tomography cervico-cerebral angiography (CTCCA) plays a pivotal role in the evaluation of acute stroke. Currently no evidence justifies the inclusion of the upper chest in the CTCCA field of view. The aim of this study was to assess the prevalence and clinical significance of vascular findings identified on CTCCA in the head, neck, and upper chest regions in patients presenting with acute stroke symptoms.

Methods

A retrospective review of radiology images and reports of 900 consecutive patients (425 men, 475 women; mean age 63.2 years, age range 19–99 years) with a suspected acute stroke who underwent CTCCA in the emergency department between January 2011 and July 2016. Clinically significant vascular CTCCA findings were recorded for each patient within the head, neck, and upper chest regions, respectively.

Results

Of the 900 patients, clinically significant vascular CTCCA findings were identified in 404/900 (44.8%) patients. 218/900 (24.2%) were located within the head region; 174/900 (19.3%) within the neck; and 12/900 (2.4%) in the upper chest. Of the 12 vascular findings located within the upper chest, 3/900 (0.33%) were related to a clinically significant posterior circulation infarct.

Conclusions

Routine inclusion of the upper chest on CTCCA is currently difficult to justify in the evaluation of a suspected acute anterior circulation stroke, contributing significantly to total radiation dose without demonstrating significant extra-cranial vascular findings. Prospective studies adopting narrower fields of view excluding the upper chest are necessary.

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Titel: CT cervico-cerebral angiography in acute stroke. Can we justify aortic arch imaging?
verfasst von: Gavin Sugrue
Michael K. O’Reilly
Danielle Byrne
Matthew T. Crockett
Sean Murphy
Eoin C. Kavanagh
Publikationsdatum: 24.08.2018
Verlag: Springer London
Erschienen in: Irish Journal of Medical Science (1971 -) / Ausgabe 2/2019
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI: https://doi.org/10.1007/s11845-018-1888-9

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