Purpose: To assess the potential of a single-session multidetector computed tomography (CT) protocol, as compared with established methods, for the etiologic work-up of acute ischemic stroke.
Materials And Methods: Patients found to have recently experienced an ischemic stroke were recruited for this prospective study after institutional review board approval was obtained. Each patient was scheduled for two evaluation strategies: (a) a standard approach involving transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE), duplex ultrasonography (US) of the neck vessels, and magnetic resonance (MR) angiography of the neck and brain vessels; and (b) a protocol involving single-session multidetector CT of the heart, neck, and brain vessels. The authors sought to determine the major etiologic factors of stroke, including cardiac sources of embolism and atheroma of the aortic arch and the extra- and intracranial vessels, by using both strategies.
Results: Multidetector CT, MR imaging, and duplex US were performed in 46 patients, 39 of whom also underwent TEE. The sensitivity and specificity of multidetector CT were 72% (18 of 25 cases) and 95% (20 of 21 cases), respectively, for detection of cardiac sources and 100% (24 of 24 cases) and 91% (20 of 22 cases), respectively, for detection of major arterial atheroma. For the 46 cases of stroke, the final etiologic classifications determined by using the standard combination approach were cardiac sources in 20 (44%) cases, major arterial atheroma in nine (20%), multiple sources in four (9%), and cryptogenic sources in 13 (28%). Multidetector CT facilitated correct etiologic classification for 38 (83%) of the 46 patients.
Conclusion: Multidetector CT is a promising tool for etiologic assessment of ischemic stroke, although the identification of minor cardiac sources with this examination requires the establishment of robust criteria.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1148/radiol.10100804 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical and radiological characteristics of calcified cerebral embolism: a large case series including 242 calcified cerebral embolism.
Acta Neurol Belg
January 2025
Department of Neurology, CHU Nîmes, Hôpital Carémeau, Univ. Montpellier, Rue du Pr Debré, Nîmes, 30900, France.
Introduction: Radiological calcified cerebral embolism (CCE) characteristics have been reported in small case series. Our aim was to describe clinical and radiological CCE characteristics in a large number of CCE and to compare characteristics between different patient groups.
Methods: Characteristics of 79 stroke patients with CCE were analyzed retrospectively.
Comparing the Introduction and Implementation of Noninvasive Prenatal Testing (NIPT) in Japan, the Netherlands, and the United States: An Integrative Review.
Prenat Diagn
January 2025
Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
Previous studies suggest that NIPT's implementation differed widely across countries but offer limited insight into what shaped these differences. To address this gap, we conducted an in-depth analysis of how NIPT was incorporated into prenatal care in the US, the Netherlands, and Japan-countries with similar economic status-to identify actionable lessons. We conducted an integrative literature review on the process of introducing and implementing NIPT, stakeholders' roles, documented considerations in the decision to introduce NIPT, implementation choices, and NIPT uptake.
View Article and Find Full Text PDFUnveiling the toxicity of micro-nanoplastics: A systematic exploration of understanding environmental and health implications.
Toxicol Rep
June 2025
Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur 56000, Malaysia.
The surge in plastic production has spurred a global crisis as plastic pollution intensifies, with microplastics and nanoplastics emerging as notable environmental threats. Due to their miniature size, these particles are ubiquitous across ecosystems and pose severe hazards as they are ingested and bioaccumulate within organisms. Although global plastic production has reached an alarming 400.
View Article and Find Full Text PDFConventional and regionally distinctive risk factors for first-onset myocardial infarction: the Bangladesh Risk of Acute Vascular Events (BRAVE) case-control study.
Lancet Reg Health Southeast Asia
January 2025
British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Background: South Asians may be particularly susceptible to premature myocardial infarction (MI) owing both to conventional cardiovascular risk factors and practices distinctive to South Asia. Identifying modifiable risk factors for MI in these populations could inform prevention strategies. We have, therefore, studied conventional risk factors and other characteristics in relation to occurrence of first MI in Bangladesh.
View Article and Find Full Text PDFDifferences in immune cells and gene expression in human milk by parity on integrated scRNA sequencing.
Clin Exp Pediatr
January 2025
Department of Internal Medicine, Section of Rheumatology, Allergy & Immunology, Yale University School of Medicine, New Haven, CT, United States.
Background: Human breast milk (HBM) is an important source of tolerogenic immune mediators that influence the infant immune system. HBM-derived immune components are affected by various factors; however, few studies have examined the relationship between parity and immune cell profiles of HBM.
Purpose: This study aimed to clarify the effects of parity on HBM immune cell heterogeneity and gene expression by integrating and analyzing publicly available single-cell RNA sequencing datasets.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!