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Abstract
Background and purpose 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.
- Stroke
- Hemorrhage
- CT
- Angiography
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Footnotes
Contributors Guarantor of the integrity of the entire study: M-NP. Study concepts: MK and M-NP. Study design: M-NP, JRL, IT, and ACH. Definition of intellectual content: M-NP, IT, and JRL. Literature research: M-NP, JRL, DB, and KS. Clinical studies: IT, JRL, DB, KS, and ACH. Data acquisition: IT, JRL, DB, and KS. Data analysis: M-NP, MK, IP, and ACH. Statistical analysis: M-NP, JRL, and IP. Manuscript preparation: M-NP, JL, and JRL. Manuscript editing: M-NP and DB. Manuscript review: M-NP, MK, JL, and IP.
Competing interests The Department of Neuroradiology, University Medicine Goettingen, has a research agreement with Siemens Healthcare GmbH, Forchheim, Germany.
Ethics approval The study was approved by theethics committee of University Medicine Goettingen. The ethics committee of our hospital waived the need for a formal application or informed patient consent due to the retrospective design of this study.
Provenance and peer review Not commissioned; externally peer reviewed.
Previous or future presentations
DGNR, October 2016, German Neuroradiology Society Meeting, Cologne, Germany;
International Stroke Conference, February 2017, Houston, Texas, USA.