PURPOSE: To assess the use of nonstandard, variable window width and level review settings in computed tomography (CT) without contrast material administration in the detection of acute stroke. MATERIALS AND METHODS: Nonenhanced CT was performed in 21 patients with acute (< 6 hours) middle cerebral arterial stroke and nine control patients. Two blinded neuroradiologists rated all scans for presence of parenchymal hypoattenuation. Images were reviewed at a picture archiving and communication system (PACS) workstation, with standard, locally determined center level and window width settings of 20 and 80 HU and with variable soft-copy settings initially centered at a level of 32 HU with a width of 8 HU. Reviewers altered settings to accentuate gray and white matter contrast. RESULTS: With standard viewing parameters, sensitivity and specificity for stroke detection were 57% and 100%. Sensitivity increased to 71% with variable window width and center level settings, without loss of specificity. Receiver operating characteristic analysis revealed a significant improvement in accuracy with nonstandard, soft-copy review settings (P = .03, one-tailed z test). CONCLUSION: In nonehanced CT of the head, detection of ischemic brain parenchyma is facilitated by soft-copy review with variable window width and center level settings to accentuate the contrast between normal and edematous tissue.
PURPOSE: To assess the use of nonstandard, variable window width and level review settings in computed tomography (CT) without contrast material administration in the detection of acute stroke. MATERIALS AND METHODS: Nonenhanced CT was performed in 21 patients with acute (< 6 hours) middle cerebral arterial stroke and nine control patients. Two blinded neuroradiologists rated all scans for presence of parenchymal hypoattenuation. Images were reviewed at a picture archiving and communication system (PACS) workstation, with standard, locally determined center level and window width settings of 20 and 80 HU and with variable soft-copy settings initially centered at a level of 32 HU with a width of 8 HU. Reviewers altered settings to accentuate gray and white matter contrast. RESULTS: With standard viewing parameters, sensitivity and specificity for stroke detection were 57% and 100%. Sensitivity increased to 71% with variable window width and center level settings, without loss of specificity. Receiver operating characteristic analysis revealed a significant improvement in accuracy with nonstandard, soft-copy review settings (P = .03, one-tailed z test). CONCLUSION: In nonehanced CT of the head, detection of ischemic brain parenchyma is facilitated by soft-copy review with variable window width and center level settings to accentuate the contrast between normal and edematous tissue.
Authors: Olvert A Berkhemer; Shervin Kamalian; R Gilberto González; Charles B L M Majoie; Albert J Yoo Journal: Cardiovasc Eng Technol Date: 2013-12-01 Impact factor: 2.495
Authors: A Z Copelan; E R Smith; G T Drocton; K H Narsinh; D Murph; R S Khangura; Z J Hartley; A A Abla; W P Dillon; C F Dowd; R T Higashida; V V Halbach; S W Hetts; D L Cooke; K Keenan; J Nelson; D Mccoy; M Ciano; M R Amans Journal: AJNR Am J Neuroradiol Date: 2020-11-19 Impact factor: 3.825