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  • Knauth, Michael  (3)
  • Leyhe, Johanna Rosemarie  (3)
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  • 1
    In: Journal of NeuroInterventional Surgery, BMJ, Vol. 9, No. 12 ( 2017-12), p. 1253-1257
    Kurzfassung: Flat detector CT (FDCT) has been used as a peri-interventional diagnostic tool in numerous studies with mixed results regarding image quality and detection of intracranial lesions. We compared the diagnostic aspects of the latest generation FDCT with standard multidetector CT (MDCT). Materials and methods 102 patients were included in our retrospective study. All patients had undergone interventional procedures. FDCT was acquired peri-interventionally and compared with postinterventional MDCT regarding depiction of ventricular/subarachnoidal spaces, detection of intracranial hemorrhage, and delineation of ischemic lesions using an ordinal scale. Ischemic lesions were quantified with the Alberta Stroke Program Early CT Scale (ASPECTS) on both examinations. Two neuroradiologists with varying grades of experience and a medical student scored the anonymized images separately, blinded to the clinical history. Results The two methods were of equal diagnostic value regarding evaluation of the ventricular system and the subarachnoidal spaces. Subarachnoidal, intraventricular, and parenchymal hemorrhages were detected with a sensitivity of 95%, 97%, and 100% and specificity of 97%, 100%, and 99%, respectively, using FDCT. Gray–white differentiation was feasible in the majority of FDCT scans, and ischemic lesions were detected with a sensitivity of 71% on FDCT, compared with MDCT scans. The mean difference in ASPECTS values on FDCT and MDCT was 0.5 points (95% CI 0.12 to 0.88). Conclusions The latest generation of FDCT is a reliable and accurate tool for the detection of intracranial hemorrhage. Gray–white differentiation is feasible in the supratentorial region.
    Materialart: Online-Ressource
    ISSN: 1759-8478 , 1759-8486
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2017
    ZDB Id: 2506028-4
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
  • 2
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. 11 ( 2017-11), p. 3152-3155
    Kurzfassung: Intrahospital time delays significantly affect the neurological outcome of stroke patients with large-vessel occlusion. This study was conducted to determine whether a one-stop management can reduce intrahospital times of patients with acute large-vessel occlusion. Methods— In this observational study, we report the first 30 consecutive stroke patients imaged and treated in the same room. As part of our protocol, we transported patients with a National Institutes of Health Stroke Scale score of ≥10 directly to the angio suite, bypassing multidetector computed tomography (CT). Preinterventional imaging consisted of noncontrast flat detector CT and flat detector CT angiography, acquired with an angiography system. Patients with large-vessel occlusions remained on the angio table and were treated with mechanical thrombectomy; patients with small artery occlusions were treated with intravenous thrombolysis, whereas patients with an intracranial hemorrhage and stroke mimics were treated as per guidelines. Door-to-groin puncture times were recorded and compared with our past results. Results— Thirty patients were transferred directly to our angio suite from June to December 2016. The time from symptom onset to admission was 105 minutes. Ischemic stroke was diagnosed in 22 of 30 (73%) patients, 4 of 30 (13.5%) had an intracranial hemorrhage, and 4 of 30 (13.5) were diagnosed with a Todd’s paresis. Time from admission to groin puncture was 20.5 minutes. Compared with 44 patients imaged with multidetector CT in the first 6 months of 2016, door-to-groin times were significantly reduced (54.5 minutes [95% confidence interval, 47–61] versus 20.5 minutes [95% confidence interval, 17–26] ). Conclusions— In this small series, a one-stop management protocol of selected stroke patients using latest generation flat detector CT led to a significant reduction of intrahospital times.
    Materialart: Online-Ressource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2017
    ZDB Id: 1467823-8
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. suppl_1 ( 2017-02)
    Kurzfassung: Background and Purpose: Flat detector CT has been used as a periinterventional diagnostic tool in numerous studies with mixed results regarding image quality and detection of intracranial lesions. We compared the diagnostic aspects of the latest generation flat detector CT to a standard multidetector CT. Materials and Methods: One hundred and two patients were included in our retrospective study. All patients had undergone interventional procedures; flat detector CT was acquired periinterventionally and compared to a postinterventional multidetector CT regarding the depiction of ventricular/subarachnoidal spaces, the detection of intracranial hemorrhage and the delineation of ischemic lesions by using an ordinal scale. Ischemic lesions were quantified with the Alberta Stroke Program Early CT score on both exams. Two neuroradiologists of various experience grades and a medical student scored the anonymized images, blinded to clinical history. Results: The two methods were diagnostic equal in evaluating the ventricular system and the subarachnoidal spaces. Subarachnoidal, intraventicular and intraparenchymal hemorrhages were detected with a sensitivity of 95%, 94%, 100% and specificity of 97%, 97% and 99% respectively using flat detector CT. Grey-white differentiation was feasible in the majority of flat detector CT scans and ischemic lesions were detected with a sensitivity of 71% on flat detector CT, compared to multidetector CT scans. Alberta Stroke Program Early CT score values correlated highly with a correlation coefficient of r=0,78. Conclusion: The latest generation of flat detector CT is a reliable tool for the detection of intracranial hemorrhage and extended ischemic lesions. Flat detector CT acquired with angiography systems could be increasingly used in acute stroke diagnostics (so called one stop imaging) with a massive impact in door to groin times.
    Materialart: Online-Ressource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2017
    ZDB Id: 1467823-8
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
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