Combination of noninvasive neurovascular imaging modalities in stroke patients: patterns of use and impact on need for digital subtraction angiography

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
Ameer E HassanAdnan I Qureshi

Abstract

The diagnostic work-up of acute stroke relies on the use of proper imaging studies. We sought to determine the use of a combination of 2 noninvasive tests, namely magnetic resonance angiography (MRA) and computed tomographic angiography (CTA) in diagnosing vascular lesions and the necessity for a subsequent digital subtraction angiography (DSA) for the definitive diagnosis. Patients admitted to 2 comprehensive stroke centers between January 2008 and July 2010 who had an equivocal initial noninvasive test were reviewed. The proportions of patients who underwent CTA and MRA in combination and those who required additional DSA for definitive diagnosis were determined. The diagnostic yield and impact on management in patients with CTA and MRA combination was compared with patients who underwent CTA and MRA followed by DSA. Among a total of 1063 patients (mean age ± SD 63 ± 16), 384 (36%) underwent >1 vascular imaging study. There was no difference in the rates of cardiovascular risk factors and stroke subtype between different combination groups. The agreement between CTA and MRA was high (concordance 81%). Among the 164 patients who underwent both CTA and MRA, a DSA was required for resolution/confirmation in only 27 (16%) patient...Continue Reading

References

Feb 8, 2003·Stroke; a Journal of Cerebral Circulation·P M RothwellUNKNOWN European Carotid Surgery Trialist's Collaboration
Sep 24, 2005·Annals of Neurology·Jean Marie U-King-ImJonathan H Gillard
Sep 1, 2006·The New England Journal of Medicine·Jonathan L BrismanDavid W Newell
May 26, 2007·Stroke; a Journal of Cerebral Circulation·Adnan I QureshiWayne H Giles
Oct 3, 2009·Stroke; a Journal of Cerebral Circulation·Richard E LatchawUNKNOWN American Heart Association Council on Cardiovascular Radiology and Intervention, Stroke Council, and the Interdisciplinary C
Mar 17, 2010·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Sasikhan GeibprasertTimo Krings

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Citations

Sep 7, 2013·Lancet·Adnan I Qureshi, Louis R Caplan
Apr 21, 2016·Translational Research : the Journal of Laboratory and Clinical Medicine·Ziad A HageFady T Charbel
Sep 5, 2015·Clinical Neuroradiology·W ReithO Jansen
Dec 7, 2019·AJNR. American Journal of Neuroradiology·E BeheshtianD M Yousem

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