07 Dec Expanded CT protocol spots stroke’s origin, changes treatment

DiagnosticImaging.com | November 22 – CT protocols for ischemic stroke can be expanded to cover the heart as well as the head and neck, obviating other imaging tests that may be necessary to pinpoint the source of the stroke, a new study finds.

A new study recommends using CT to pinpoint the cause of ischemic stroke as a way to improve treatment for patients. The research followed up an MR diagnosis with CT to pinpoint the stroke’s origin. The recommendations are in line with those of the American Academy of Neurology, which recommends the use of MR to diagnose stroke.

The researchers looked specifically at ischemic stroke, which can originate in the heart or from blood vessels in the neck and head. They analyzed the potential of multislice CT as a fast and cost-effective way to detect the main causes of ischemic stroke. The investigators compared a single-session MSCT examination of the heart, neck, and brain vessels with established imaging methods in 46 patients who had recently experienced an ischemic stroke.

Typically, physicians determine the cause of stroke using duplex ultrasonography, MR angiography, or CT angiography of the neck and brain vessels and transthoracic and transesophageal echocardiography.

Almost half the stroke cases had cardiac sources, while 20% were caused by major arterial atherosclerosis.

MSCT detected cardiac sources of stroke in 18 of 25 cases, for a sensitivity of 72%. The technique’s sensitivity increased to 100% for detection of major arterial atherosclerosis. Overall, MSCT facilitated stroke classification in 38 of the 46 patients, or 83%.

“CT allows a fast diagnosis and helps to identify the cause of the stroke during a single examination,” said Dr. Loic Boussel, a professor of radiology at Louis Pradel Hospital in Bron, France, and lead author of the study. “Moreover, because it is quick, the exam is well tolerated, which is critical in acute stroke patients who may be unstable and agitated.”

When physicians know where a stroke originates, they can treat it accordingly.

Read more on diagnosticimaging.com.