M Ernst1, J M Romero, J H Buhk, A Kemmling, J Fiehler, M Groth. 1. Center for Radiology and Endoscopy Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Haus Ost 22 (O 22) Martinistr 52, 20246, Hamburg, Germany, m.ernst@uke.de.
Abstract
INTRODUCTION: This study aims to investigate diagnostic sensitivity and reliability for the detection of middle cerebral artery occlusion (MCAO) on non-contrast-enhanced computed tomography (NECT) by visual assessment (VA), Hounsfield unit (HU) measurement, calculation of the Hounsfield unit/hematocrit (HU/Hct) ratio, and combination of visual assessment and attenuation measurement (VA + HU). METHODS: NECT of 18 patients with angiographically proven MCAO and 18 patients without MCAO were reviewed by two blinded observers. Visual assessment of presence or absence of a hyperdense sign was followed by HU measurement of both middle cerebral arteries (MCA). Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for VA, HU measurement, HU/Hct ratio, and VA + HU measurement. Receiver operating characteristic curve analysis (ROC) was performed to determine the optimal cut-off values for MCAO using attenuation measurements or HU/Hct ratio. RESULTS: Diagnostic sensitivity/specificity was 63%/91% for VA, 56%/88% for attenuation measurement, 68 %/81 % for HU/Hct ratio, and 75%/78% for VA + HU. ROC curve analysis revealed cut-off values of >42.5 HU for attenuation measurements and >1.12 HU/Hct for HU/Hct ratio. CONCLUSION: Combination of visual assessment with additional attenuation measurement with a cut-off value of 42.5 HU is recommended for most sensitive and reliable detection of MCAO on NECT.
INTRODUCTION: This study aims to investigate diagnostic sensitivity and reliability for the detection of middle cerebral artery occlusion (MCAO) on non-contrast-enhanced computed tomography (NECT) by visual assessment (VA), Hounsfield unit (HU) measurement, calculation of the Hounsfield unit/hematocrit (HU/Hct) ratio, and combination of visual assessment and attenuation measurement (VA + HU). METHODS: NECT of 18 patients with angiographically proven MCAO and 18 patients without MCAO were reviewed by two blinded observers. Visual assessment of presence or absence of a hyperdense sign was followed by HU measurement of both middle cerebral arteries (MCA). Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for VA, HU measurement, HU/Hct ratio, and VA + HU measurement. Receiver operating characteristic curve analysis (ROC) was performed to determine the optimal cut-off values for MCAO using attenuation measurements or HU/Hct ratio. RESULTS: Diagnostic sensitivity/specificity was 63%/91% for VA, 56%/88% for attenuation measurement, 68 %/81 % for HU/Hct ratio, and 75%/78% for VA + HU. ROC curve analysis revealed cut-off values of >42.5 HU for attenuation measurements and >1.12 HU/Hct for HU/Hct ratio. CONCLUSION: Combination of visual assessment with additional attenuation measurement with a cut-off value of 42.5 HU is recommended for most sensitive and reliable detection of MCAO on NECT.
Authors: Tracy A Jaffe; Jenny K Hoang; Terry T Yoshizumi; Greta Toncheva; Carolyn Lowry; Carl Ravin Journal: AJR Am J Roentgenol Date: 2010-08 Impact factor: 3.959
Authors: R von Kummer; U Meyding-Lamadé; M Forsting; L Rosin; K Rieke; W Hacke; K Sartor Journal: AJNR Am J Neuroradiol Date: 1994-01 Impact factor: 3.825
Authors: Simiao Wu; Grant Mair; Geoff Cohen; Zoe Morris; Anders von Heijne; Nick Bradey; Lesley Cala; Andre Peeters; Andrew J Farrall; Alessandro Adami; Gillian Potter; Ming Liu; Richard I Lindley; Peter A G Sandercock; Joanna M Wardlaw Journal: Stroke Vasc Neurol Date: 2020-11-27