Variability of acquisition phase of computed tomography angiography in acute ischemic stroke in a real-world scenario

Objectives The informative value of computed tomography angiography (CTA) depends on the contrast phase in the vessels which may differ depending on the level of local expertise. - Methods We retrospectively measured vessel contrast density from CTA scans in patients presenting with acute ischemic s...

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Hauptverfasser: Pfaff, Johannes (VerfasserIn) , Füssel, Bianka (VerfasserIn) , Harlan, Marcial E. (VerfasserIn) , Hubert, Alexander (VerfasserIn) , Bendszus, Martin (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2022
In: European radiology
Year: 2022, Jahrgang: 32, Heft: 1, Pages: 281-289
ISSN:1432-1084
DOI:10.1007/s00330-021-08084-5
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1007/s00330-021-08084-5
Verlag, kostenfrei, Volltext: https://link.springer.com/10.1007/s00330-021-08084-5
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Verfasserangaben:Johannes A.R. Pfaff, Bianka Füssel, Marcial E. Harlan, Alexander Hubert, Martin Bendszus

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520 |a Objectives The informative value of computed tomography angiography (CTA) depends on the contrast phase in the vessels which may differ depending on the level of local expertise. - Methods We retrospectively measured vessel contrast density from CTA scans in patients presenting with acute ischemic stroke to a comprehensive stroke center (CSC) or to one of eight primary stroke centers (PSC). CTAs were classified into arterial or venous phases as well as into 1 of 5 phases (early arterial, peak arterial, equilibrium, peak venous, and late venous). - Results Overall, n = 871 CTAs (CSC: n = 431 (49.5%); PSC: n = 440 (50.5%)) were included in the final analysis. A higher venous than arterial contrast density at the level of the circle of Willis was only rarely observed (overall n = 13 (1.5%); CSC: n = 3/431 (0.7%); PCS: n = 10/440 (2.3%); p = 0.09). CTAs acquired in the CSC showed more often an early arterial contrast phase (CSC: n = 371 (86.1%); PSC: n = 153 (34.8%), p < 0.01). Equilibrium contrast phase, i.e., a slightly stronger arterial contrast with clear venous contrast filling, was more frequent in CTAs from the PSCs (CSC: n = 6 (1.4%); PSC: n = 47 (10.7%); p < 0.01). - Conclusions Despite different technical equipment and examination protocols, the overall number of CTAs with venous contrast was low and did not differ between the CSC and the PCSs. Differences between the further differentiated contrast phases indicate potential for further improvement of CTA acquisition protocols. 
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