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Detection of Early Ischemic Changes in Noncontrast CT Head Improved with “Stroke Windows”

Introduction. Noncontrast head CT (NCCT) is the standard radiologic test for patients presenting with acute stroke. Early ischemic changes (EIC) are often overlooked on initial NCCT. We determine the sensitivity and specificity of improved EIC detection by a standardized method of image evaluation (...

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Autores principales: Mainali, Shraddha, Wahba, Mervat, Elijovich, Lucas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045559/
https://www.ncbi.nlm.nih.gov/pubmed/24967315
http://dx.doi.org/10.1155/2014/654980
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author Mainali, Shraddha
Wahba, Mervat
Elijovich, Lucas
author_facet Mainali, Shraddha
Wahba, Mervat
Elijovich, Lucas
author_sort Mainali, Shraddha
collection PubMed
description Introduction. Noncontrast head CT (NCCT) is the standard radiologic test for patients presenting with acute stroke. Early ischemic changes (EIC) are often overlooked on initial NCCT. We determine the sensitivity and specificity of improved EIC detection by a standardized method of image evaluation (Stroke Windows). Methods. We performed a retrospective chart review to identify patients with acute ischemic stroke who had NCCT at presentation. EIC was defined by the presence of hyperdense MCA/basilar artery sign; sulcal effacement; basal ganglia/subcortical hypodensity; and loss of cortical gray-white differentiation. NCCT was reviewed with standard window settings and with specialized Stroke Windows. Results. Fifty patients (42% females, 58% males) with a mean NIHSS of 13.4 were identified. EIC was detected in 9 patients with standard windows, while EIC was detected using Stroke Windows in 35 patients (18% versus 70%; P < 0.0001). Hyperdense MCA sign was the most commonly reported EIC; it was better detected with Stroke Windows (14% and 36%; P < 0.0198). Detection of the remaining EIC also improved with Stroke Windows (6% and 46%; P < 0.0001). Conclusions. Detection of EIC has important implications in diagnosis and treatment of acute ischemic stroke. Utilization of Stroke Windows significantly improved detection of EIC.
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spelling pubmed-40455592014-06-25 Detection of Early Ischemic Changes in Noncontrast CT Head Improved with “Stroke Windows” Mainali, Shraddha Wahba, Mervat Elijovich, Lucas ISRN Neurosci Clinical Study Introduction. Noncontrast head CT (NCCT) is the standard radiologic test for patients presenting with acute stroke. Early ischemic changes (EIC) are often overlooked on initial NCCT. We determine the sensitivity and specificity of improved EIC detection by a standardized method of image evaluation (Stroke Windows). Methods. We performed a retrospective chart review to identify patients with acute ischemic stroke who had NCCT at presentation. EIC was defined by the presence of hyperdense MCA/basilar artery sign; sulcal effacement; basal ganglia/subcortical hypodensity; and loss of cortical gray-white differentiation. NCCT was reviewed with standard window settings and with specialized Stroke Windows. Results. Fifty patients (42% females, 58% males) with a mean NIHSS of 13.4 were identified. EIC was detected in 9 patients with standard windows, while EIC was detected using Stroke Windows in 35 patients (18% versus 70%; P < 0.0001). Hyperdense MCA sign was the most commonly reported EIC; it was better detected with Stroke Windows (14% and 36%; P < 0.0198). Detection of the remaining EIC also improved with Stroke Windows (6% and 46%; P < 0.0001). Conclusions. Detection of EIC has important implications in diagnosis and treatment of acute ischemic stroke. Utilization of Stroke Windows significantly improved detection of EIC. Hindawi Publishing Corporation 2014-03-09 /pmc/articles/PMC4045559/ /pubmed/24967315 http://dx.doi.org/10.1155/2014/654980 Text en Copyright © 2014 Shraddha Mainali et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Mainali, Shraddha
Wahba, Mervat
Elijovich, Lucas
Detection of Early Ischemic Changes in Noncontrast CT Head Improved with “Stroke Windows”
title Detection of Early Ischemic Changes in Noncontrast CT Head Improved with “Stroke Windows”
title_full Detection of Early Ischemic Changes in Noncontrast CT Head Improved with “Stroke Windows”
title_fullStr Detection of Early Ischemic Changes in Noncontrast CT Head Improved with “Stroke Windows”
title_full_unstemmed Detection of Early Ischemic Changes in Noncontrast CT Head Improved with “Stroke Windows”
title_short Detection of Early Ischemic Changes in Noncontrast CT Head Improved with “Stroke Windows”
title_sort detection of early ischemic changes in noncontrast ct head improved with “stroke windows”
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045559/
https://www.ncbi.nlm.nih.gov/pubmed/24967315
http://dx.doi.org/10.1155/2014/654980
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