Medizinische Universität Graz - Research portal
Selected Publication:
Wong, S.
A retrospective analysis of single rotation CTA of the neck in cerebral whole brain CT-Perfusion – evaluation of a one-stop-imaging CT stroke protocol.
Studium für die Gleichwertigkeit; Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2020. pp. 53
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- Authors Med Uni Graz:
- Advisor:
- Deutschmann Hannes
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- Abstract:
- Introduction:Large volume-CT scanners with 16 cm z-axis single rotation coverage enable joggle-mode scanning of cerebral CT-perfusion (CTP) and single rotation CTA (srCTA) of cervical arteries. The time needed to perform diagnostic imaging in stroke patients could therefore be shortened. Purpose: Our study aims to evaluate the feasibility of scanning cervical arteries, acquired with srCTA during CTP in ischemic stroke patients. Methods and Materials: 143 patients were scanned with single contrast medium (CM) injection of 60 ml. Hounsfield Units (HU) of cervical arteries and veins were objectively measured. Carotid bifurcations were analysed qualitatively and also correlated with DSA. Incidence of artefacts and supra-aortic vessels coverage were recorded. Results: srCTA of the was able to depict the supra-aortic vessels from their origin at the aortic arch in 58 (40.6%) patients. 94.8% (1140/1152) of arterial segments were adequately opacified (≥ 150 HU). Arteries were adequately contrasted compared to veins in 81.3% (915/1126) segments. However the opacification was reversed in 14.0% (158/1126) of the segments, indicating delayed timing of acquisition. 95.5% (273/286) of the carotid bifurcations were of good image quality. Measurement of ICA stenosis in srCTA according to NASCET correlated well with DSA (R = 0.87, p < 0.05). In 22.4% (32/143) of the patients were the images significantly affected by at least one artefact, mainly from metal/dental implants (10.5%), congested contrast in central veins (7.7%) and shoulder region (4.9%). Conclusion: srCTA of neck incorporated into cerebral CTP with single CM administration revealed adequate image quality for further decision making in our patient cohort. Main drawbacks were inadequate coverage of supra-aortic arteries and possible delay in timing of the joggle.