Incidental Findings on Whole-Body Computed Tomography Angiography in Patients With Suspected Acute Stroke

Introduction Whole-body computed tomography angiography (CTA) may be useful during cerebral angiography and endovascular treatment (EVT), and identification of thrombi and malignant trunk tumors may be helpful in stroke typing and acute stroke care. Therefore, we aimed to assess the types and prevalence of incidental findings on whole-body CTA in this patient population. Methods This single-center, retrospective, observational study included consecutive patients with suspected acute stroke who underwent whole-body CTA in addition to brain CTA between April 2020 and August 2023. Whole-body CTA findings, including vascular lesions, malignancies, and thrombi, were retrospectively collected from medical records and radiology reports. We analyzed data from 290 patients (167 with ischemic stroke, 53 with subarachnoid hemorrhage, 38 with hemorrhagic stroke, and 32 with non-stroke). Results The median age was 76.0 years, and the median National Institutes of Health Stroke Scale score on admission was 10. One hundred twenty-three patients (42.4%) underwent digital subtraction angiography (DSA). Of the 38 whole-body CTA findings for patients with suspected acute stroke, 19 were vascular lesions, seven were malignancies, and 12 were thrombi. Conclusion These findings show that malignancy and thrombosis, in addition to vascular lesions, can be detected when whole-body CTA is performed in patients with suspected acute stroke.