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

Gavin Sugrue1, Michael K O'Reilly2, Danielle Byrne2

  • 1Department of Radiology, Mater Misericordiae University Hospital, Dublin 7, Ireland. g_sugrue@hotmail.com.

Irish Journal of Medical Science
|August 26, 2018
PubMed

Insights

Computed tomography cervico-cerebral angiography (CTCCA) for acute stroke rarely reveals significant upper chest vascular findings. Excluding the upper chest may reduce radiation dose without impacting diagnosis for anterior circulation strokes.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Imaging

Background:

  • Computed tomography cervico-cerebral angiography (CTCCA) is crucial for acute stroke evaluation.
  • Current evidence does not support including the upper chest in the CTCCA field of view.

Purpose of the Study:

  • To determine the prevalence and clinical significance of vascular findings in the head, neck, and upper chest on CTCCA in acute stroke patients.

Main Methods:

  • Retrospective review of 900 patients undergoing CTCCA for suspected acute stroke.
  • Analysis of radiology images and reports for clinically significant vascular findings in the head, neck, and upper chest.

Main Results:

  • Clinically significant vascular findings were present in 44.8% of patients.
  • Findings were located in the head (24.2%), neck (19.3%), and upper chest (2.4%).
  • Only 0.33% of upper chest findings were related to posterior circulation infarcts.

Conclusions:

  • Routine inclusion of the upper chest in CTCCA is not justified for anterior circulation stroke evaluation.
  • Excluding the upper chest may reduce radiation dose without compromising diagnosis.
  • Further prospective studies with narrower fields of view are recommended.
Abstract

Keywords:
Computed tomography angiographyStroke

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