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4D-CTA improves diagnostic certainty and accuracy in the detection of proximal intracranial anterior circulation occlusion in acute ischemic stroke

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  • Bart A J M Wagemans
  • Wim H van Zwam
  • Patricia J Nelemans
  • Robert J van Oostenbrugge
  • Alida A Postma

Abstract

Introduction: In acute ischemic stroke, imaging of the cranio-cervical vessels is essential for intra-arterial treatment selection. Fast, reliable and easy accessible imaging is necessary 24 hours a day, 7 days a week. Radiologists in training and non-expert readers often perform initial reviewing. In this pilot study, the potential benefit of adding 4Dimensional-CT Angiography (4D-CTA) to the patient selection protocol for intra-arterial therapy is investigated. Materials and methods: Twenty-five datasets of prospectively recruited patients, eligible for intra-arterial treatment, were enrolled. Four radiologists-in-training consecutively reviewed CTA, CT-Perfusion and 4D-CTA (post-processed from CTP datasets) and scored: occlusion-presence and diagnostic certainty (scale 1–10). Time-to-diagnosis was registered. Results: Arterial occlusion was present in 8 patients. Accuracy improved from 88–92% after CTA and CTP assessment to 96–100% after 4D-CTA assessment (P-values >0,05). Mean diagnostic certainty improved from 7,2–8,6 to 8,8–9,3 (P-values all

Suggested Citation

  • Bart A J M Wagemans & Wim H van Zwam & Patricia J Nelemans & Robert J van Oostenbrugge & Alida A Postma, 2017. "4D-CTA improves diagnostic certainty and accuracy in the detection of proximal intracranial anterior circulation occlusion in acute ischemic stroke," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-10, February.
    • Handle: RePEc:plo:pone00:0172356
    DOI: 10.1371/journal.pone.0172356
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