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Nongated Cardiac Co...
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Yeo, Leonard L LKarolinska Institutet
(author)
Nongated Cardiac Computed Tomographic Angiograms for Detection of Embolic Sources in Acute Ischemic Stroke
- Article/chapterEnglish2017
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LIBRIS-ID:oai:DiVA.org:uu-348516
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-348516URI
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https://doi.org/10.1161/STROKEAHA.117.016903DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:135902756URI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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BACKGROUND AND PURPOSE: axis coverage of a non-ECG-gated computed tomographic angiogram performed in the primary evaluation of acute stroke without increasing the contrast dose.METHODS: Twenty consecutive patients with acute ischemic stroke within the 4.5 hours of symptom onset were prospectively recruited. We increased the longitudinal coverage to the domes of the diaphragm to include the heart. Contrast administration (Omnipaque 350) remained unchanged (injected at 3-4 mL/s; total 60-80 mL, triggered by bolus tracking). Images of the heart and aorta, reconstructed at 5 mm slice thickness in 3 orthogonal planes, were read by a radiologist and cardiologist, findings conveyed to the treating neurologist, and correlated with the transthoracic or transesophageal echocardiogram performed within the next 24 hours.RESULTS: Of 20 patients studied, 3 (15%) had abnormal findings: a left ventricular thrombus, a Stanford type A aortic dissection, and a thrombus of the left atrial appendage. Both thrombi were confirmed by transesophageal echocardiography, and anticoagulation was started urgently the following day. None of the patients developed contrast-induced nephropathy on follow-up. The radiation dose was slightly increased from a mean of 4.26 mSV (range, 3.88-4.70 mSV) to 5.17 (range, 3.95 to 6.25 mSV).CONCLUSIONS: Including the heart and ascending aorta in a routine non-ECG-gated computed tomographic angiogram enhances an existing imaging modality, with no increased incidence of contrast-induced nephropathy and minimal increase in radiation dose. This may help in the detection of high-risk cardiac and aortic sources of embolism in acute stroke patients.
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Holmin, StaffanKarolinska Institutet
(author)
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Andersson, TommyKarolinska Institutet
(author)
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Lundström, Erik,1964-Karolinska Institutet(Swepub:uu)erlun676
(author)
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Gopinathan, Anil
(author)
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Lim, Er Luen
(author)
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Leong, Benjamin S H
(author)
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Kuan, Win Sen
(author)
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Ting, Eric
(author)
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Tan, Benjamin Y Q
(author)
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Eide, Sterling Ellis
(author)
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Tay, Edgar L K
(author)
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Karolinska Institutet
(creator_code:org_t)
Related titles
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In:Stroke48:5, s. 1256-12610039-24991524-4628
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Stroke
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Yeo, Leonard L L
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Holmin, Staffan
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Andersson, Tommy
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Lundström, Erik, ...
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Gopinathan, Anil
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Lim, Er Luen
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Leong, Benjamin ...
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Kuan, Win Sen
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Ting, Eric
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Tan, Benjamin Y ...
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Eide, Sterling E ...
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Tay, Edgar L K
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
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Stroke
- By the university
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Uppsala University
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Karolinska Institutet