Comparing multislice electrocardiogram-gated spiral computerized tomography and transesophageal echocardiography in
Syed I Hussain1, Robert C Gilkeson, Jose I Suarez
1Department of Neurology, Medical College of Wisconsin/Froedtert Hospital, Milwaukee, Wisconsin 55326, USA.
Insights
Cardiac-gated computerized tomography (CGCT) and transesophageal echocardiography (TEE) are comparable in detecting aortic atherosclerosis (AA). CGCT may identify smaller AA and offer better plaque morphology details.
Area of Science:
- Cardiovascular Imaging
- Neurology
- Radiology
Background:
- Aortic atherosclerosis (AA) is a potential source of embolic material leading to ischemic stroke.
- Transesophageal echocardiography (TEE) is used for detecting cardiac emboli sources but has limitations for AA detection.
Purpose of the Study:
- To compare the efficacy of transesophageal echocardiography (TEE) and cardiac-gated computerized tomography (CGCT) in detecting aortic atherosclerosis (AA).
Main Methods:
- Prospective study of ischemic stroke patients who underwent both TEE and CGCT.
- Aortic atheroma thickness was measured in millimeters.
- Data analyzed using Bland-Altman plots, Pollock plots, and correlation tests (Pearson, Spearman, intraclass).
Main Results:
- High correlation (intraclass=0.93, r=0.82, r(s)=0.83) between CGCT and TEE in 32 patients.
- CGCT detected smaller AA more frequently than TEE.
- CGCT provided superior information on atheromatous plaque morphology.
Conclusions:
- CGCT and TEE demonstrate similar performance in detecting aortic atherosclerosis.
- CGCT offers potential advantages in identifying smaller AA and characterizing plaque morphology.
Objective:
The aim of this study was to compare transesophageal echocardiography (TEE) and cardiac-gated computerized tomography (CGCT) in detecting aortic atherosclerosis (AA).
Background:
There is evidence that AA can be a source of embolic material causing ischemic stroke. TEE is a well-established tool for detecting cardiac sources of emboli in patients with stroke, but it has distinct limitations in the detection of AA.
Method:
This was a prospective study of patients admitted with the diagnosis of ischemic stroke between February and November of 2000. Among this cohort are patients who underwent both TEE and CGCT for the evaluation of stroke cause. The CGCT studies were retrieved and interpreted by a radiologist with special expertise in chest tomography, and TEE studies were read by an echocardiographer with special expertise in reading and performing TEE. The interpreters were unaware of the results obtained by the other. The AA was estimated by measuring atheroma thickness in millimeters. The relations between the two tests were analyzed graphically using Bland-Altman, and Pollock plots. Results from Pearson (r), Spearman (r(s)), and intraclass correlation tests were also estimated.
Results:
The aortic atheroma thickness in millimeters was compared between CGCT and TEE in 32 patients, who underwent both studies. The intraclass correlation was 0.93, with high correlation (r = 082, r(s) = 0.83). CGCT detected smaller AA more often, and provided more information about the shape of atheromatous plaques.
Conclusion:
CGCT is similar to TEE in detecting AA. CGCT may detect smaller atheromas and be better in defining atheroma morphology.
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