4D-CTA improves diagnostic certainty and accuracy in the detection of proximal intracranial anterior circulation occlusion in acute ischemic stroke
In acute ischemic stroke, imaging of the cranio-cervical vessels is essential for intra-arterial treatment selection. Fast, reliable and easy accessible imaging is necessary 24 hours a day, 7 days a week. Radiologists in training and non-expert readers often perform initial reviewing. In this pilot...
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Published in | PloS one Vol. 12; no. 2; p. e0172356 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Public Library of Science
24.02.2017
Public Library of Science (PLoS) |
Subjects | |
Online Access | Get full text |
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Summary: | In acute ischemic stroke, imaging of the cranio-cervical vessels is essential for intra-arterial treatment selection. Fast, reliable and easy accessible imaging is necessary 24 hours a day, 7 days a week. Radiologists in training and non-expert readers often perform initial reviewing. In this pilot study, the potential benefit of adding 4Dimensional-CT Angiography (4D-CTA) to the patient selection protocol for intra-arterial therapy is investigated.
Twenty-five datasets of prospectively recruited patients, eligible for intra-arterial treatment, were enrolled. Four radiologists-in-training consecutively reviewed CTA, CT-Perfusion and 4D-CTA (post-processed from CTP datasets) and scored: occlusion-presence and diagnostic certainty (scale 1-10). Time-to-diagnosis was registered.
Arterial occlusion was present in 8 patients. Accuracy improved from 88-92% after CTA and CTP assessment to 96-100% after 4D-CTA assessment (P-values >0,05). Mean diagnostic certainty improved from 7,2-8,6 to 8,8-9,3 (P-values all < 0,05). Mean time to diagnosis increased from 3, 5, 5 and 4 minutes after CTA to 9, 14, 12, and 10 minutes after 4D-CTA.
4D-CTA as an additive to regular CTA and CT-Perfusion in patients with acute ischemic stroke eligible for intra-arterial treatment shows a tendency to increase diagnostic accuracy and improves diagnostic certainty, when reviewed by radiologist in training, while only mildly prolonging time to diagnosis. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: The authors have declared that no competing interests exist. Conceptualization: BAJMW AAP WHvZ RJvO.Data curation: BAJMW AAP WHvZ PJN.Formal analysis: BAJMW PJN AAP.Investigation: BAJMW AAP WHvZ RJvO.Methodology: BAJMW PJN AAJ WHvZ RJvO.Project administration: BAJMW.Resources: BAJMW AAP PJN.Software: BAJMW PJN.Supervision: AAP RJvO WHvZ.Validation: BAJMW PJN AAP.Visualization: BAJMW AAP WHvZ.Writing – original draft: BAJMW AAP WHvZ RJvO.Writing – review & editing: BAJMW AAP WHvZ RJvO. |
ISSN: | 1932-6203 1932-6203 |
DOI: | 10.1371/journal.pone.0172356 |