Purpose: To determine the optimal slice thickness of brain non-contrast computed tomography using a hybrid iterative reconstruction algorithm to identify hyperdense middle cerebral artery sign in patients with acute ischemic stroke.
Methods: We retrospectively enrolled 30 patients who had presented hyperdense middle cerebral artery sign and 30 patients who showed no acute ischemic change in acute magnetic resonance imaging. Reformatted axial images at an angle of the orbitomeatal line in slice thicknesses of 0.5, 1, 3, 5, and 7 mm were generated. Optimal slice thickness for identifying hyperdense middle cerebral artery sign was evaluated by a receiver operating characteristics curve analysis and area under the curve (AUC).
Results: The mean AUC value of 0.5-mm slice (0.921; 95% confidence interval (95% CI), 0.868 to 0.975) was significantly higher than those of 3-mm (0.791; 95% CI, 0.686 to 0.895; p = 0.041), 5-mm (0.691; 95% CI, 0.583 to 0.799, p < 0.001), and 7-mm (0.695; 95% CI, 0.593 to 0.797, p < 0.001) slices, whereas it was equivalent to that of 1-mm slice (0.901; 95% CI, 0.837 to 0.965, p = 0.751).
Conclusion: Thin slice thickness of ≤ 1 mm has a better diagnostic performance for identifying hyperdense artery sign on brain non-contrast computed tomography with a hybrid iterative reconstruction algorithm in patients with acute ischemic stroke.
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