"Our results suggest that multidetector CT could become the first-line imaging tool for identifying the cause of acute ischemic stroke," said the study's lead author, Loic Boussel, M.D., Ph.D., professor of radiology at Louis Pradel Hospital in Bron, France.
An ischemic stroke occurs when blockage in an artery, often from a blood clot or a fatty deposit due to atherosclerosis, interrupts blood flow to an area of the brain. This type of stroke can originate in the heart, in the form of a blood clot that travels to the head, or from blood vessels in the neck (extracranial carotid arteries) and head (intracranial arteries). According to the American Stroke Association, ischemic stroke accounts for approximately 87 percent of stroke cases.
Early determination of the cause of ischemic stroke is essential for secondary stroke prevention. Anticoagulant therapy to thin the blood is the treatment of choice for most of the cardiac sources of stroke, while surgery is needed for strokes caused by severe narrowing of the extracranial carotid artery.
Physicians use a combined imaging protocol to determine the cause of an ischemic stroke. The protocol typically includes duplex ultrasonography, MR angiography or CT angiography of the neck and brain vessels, and transthoracic and transesophageal echocardiography.
"This approach is time-consuming and expensive, and could delay secondary stroke prevention strategies," Dr. Boussel said.
In the new study, Dr. Boussel and colleagues analyzed the potential of multidetector CT as a faster and more cost-effective way to detect the main causes of ischemic stroke. The researchers compared a single-session multidetector CT examination of the heart, neck and brain vessels with established imaging methods in 46 patients who had recently experienced an ischemic stroke.
Almost half of the stroke cases had cardiac sources, while 20 percent of cases were caused by major arterial atherosclerosis.
Multidetector CT detected cardiac sources of stroke in 18 of 25 cases, for a sensitivity of 72 percent. The technique's sensitivity increased to 100 percent for detection of major arterial atherosclerosis. Overall, multidetector CT facilitated stroke classification in 38 of the 46 patients, or 83 percent.
"CT allows a fast diagnosis and helps to identify the cause of the stroke during a single examination," Dr. Boussel said. "Moreover, because it is quick, the exam is well tolerated, which is critical in acute stroke patients who may be unstable and agitated."
The CT protocol has two main limitations, according to Dr. Boussel. It exposes the patient to a significant radiation dose and requires two intravenous contrast material injections to study the chest and neck areas. Dr. Boussel said that advances in CT equipment technology could help reduce the radiation dose and the total amount of iodinated contrast material required.
Larger studies are needed to validate the results and to analyze the technique's cost-effectiveness.
"Ischemic Stroke: Etiologic Work-up with Multidetector CT of Heart and Extra- and Intracranial Arteries." Collaborating with Dr. Boussel were Serkan Cakmak, M.D., Max Wintermark, M.D., Ph.D., Norbert Nighoghossian, M.D., Ph.D., Romaric Loffroy, M.D., Philippe Coulon, Ph.D., Laurent Derex, M.D., Ph.D., Tae Hee Cho, M.D., and Philippe C. Douek, M.D., Ph.D.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (http://radiology.rsna.org/)
RSNA is an association of more than 46,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA.org)
For patient-friendly information on CT, visit RadiologyInfo.org.
Novel chip-based gene expression tool analyzes RNA quickly and accurately
18.01.2018 | University of Illinois College of Engineering
Potentially life-saving health monitor technology designed by Sussex University physicists
10.01.2018 | University of Sussex
On the way to an intelligent laboratory, physicists from Innsbruck and Vienna present an artificial agent that autonomously designs quantum experiments. In initial experiments, the system has independently (re)discovered experimental techniques that are nowadays standard in modern quantum optical laboratories. This shows how machines could play a more creative role in research in the future.
We carry smartphones in our pockets, the streets are dotted with semi-autonomous cars, but in the research laboratory experiments are still being designed by...
What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...
For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.
Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...
At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.
No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...
Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.
Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...
08.01.2018 | Event News
11.12.2017 | Event News
08.12.2017 | Event News
19.01.2018 | Materials Sciences
19.01.2018 | Health and Medicine
19.01.2018 | Physics and Astronomy