Abstract
BACKGROUND AND PURPOSE-: We assessed the diagnostic performance of 2-phase 64-slice cardiac computed tomographic angiography (CCTA) for the detection of a cardiac source of embolism in stroke patients using transesophageal echocardiography (TEE) as the reference standard. METHODS-: We selected 137 patients who had experienced a recent episode of stroke and had undergone both 2-phase 64-slice CCTA and TEE within a period of 5 days. A potential cardiac source of embolism detected at both CCTA and TEE was recorded, and echocardiographic findings were categorized into high- and medium-risk sources based on the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification. RESULTS-: Of 137 patients, 100 abnormal findings in 91 patients were found on TEE, and 46 patients had no abnormal finding on TEE. The overall sensitivity, specificity, positive predictive value, and negative predictive value of the 64-slice CCTA for detecting cardiac sources of embolism were 89% (95% CI, 82%, 95%), 100% (95% CI, 90%, 100%), 100% (95% CI, 95%, 100%), and 81% (95% CI, 70%, 92%), respectively. TEE detected a total of 47 high-risk sources of embolism, whereas CT detected 44 lesions. For medium-risk sources of cardiac embolic stroke, TEE detected a total of 53 abnormal findings, whereas CT detected 44 abnormal findings. Of 53 lesions, there were 8 false-negative results on CT (5 patent foramen ovale and 3 atrial septal aneurysm). CONCLUSIONS-: Two-phase 64-slice CCTA is a noninvasive and useful modality for detecting high-risk cardiac sources of embolism in stroke patients.
| Original language | English |
|---|---|
| Pages (from-to) | 2073-2078 |
| Number of pages | 6 |
| Journal | Stroke |
| Volume | 40 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2009 Jun 1 |
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All Science Journal Classification (ASJC) codes
- Clinical Neurology
- Cardiology and Cardiovascular Medicine
- Advanced and Specialised Nursing
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Cardiac computed tomographic angiography for detection of cardiac sources of embolism in stroke patients. / Hur, Jin; Kim, Young Jin; Lee, Hye Jeong; Ha, Jong Won; Heo, Ji Hoe; Choi, Eui Young; Shim, Chi Young; Kim, Tae Hoon; Nam, Ji Eun; Choe, Kyu Ok; Choi, Byoung Wook.
In: Stroke, Vol. 40, No. 6, 01.06.2009, p. 2073-2078.Research output: Contribution to journal › Article
TY - JOUR
T1 - Cardiac computed tomographic angiography for detection of cardiac sources of embolism in stroke patients
AU - Hur, Jin
AU - Kim, Young Jin
AU - Lee, Hye Jeong
AU - Ha, Jong Won
AU - Heo, Ji Hoe
AU - Choi, Eui Young
AU - Shim, Chi Young
AU - Kim, Tae Hoon
AU - Nam, Ji Eun
AU - Choe, Kyu Ok
AU - Choi, Byoung Wook
PY - 2009/6/1
Y1 - 2009/6/1
N2 - BACKGROUND AND PURPOSE-: We assessed the diagnostic performance of 2-phase 64-slice cardiac computed tomographic angiography (CCTA) for the detection of a cardiac source of embolism in stroke patients using transesophageal echocardiography (TEE) as the reference standard. METHODS-: We selected 137 patients who had experienced a recent episode of stroke and had undergone both 2-phase 64-slice CCTA and TEE within a period of 5 days. A potential cardiac source of embolism detected at both CCTA and TEE was recorded, and echocardiographic findings were categorized into high- and medium-risk sources based on the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification. RESULTS-: Of 137 patients, 100 abnormal findings in 91 patients were found on TEE, and 46 patients had no abnormal finding on TEE. The overall sensitivity, specificity, positive predictive value, and negative predictive value of the 64-slice CCTA for detecting cardiac sources of embolism were 89% (95% CI, 82%, 95%), 100% (95% CI, 90%, 100%), 100% (95% CI, 95%, 100%), and 81% (95% CI, 70%, 92%), respectively. TEE detected a total of 47 high-risk sources of embolism, whereas CT detected 44 lesions. For medium-risk sources of cardiac embolic stroke, TEE detected a total of 53 abnormal findings, whereas CT detected 44 abnormal findings. Of 53 lesions, there were 8 false-negative results on CT (5 patent foramen ovale and 3 atrial septal aneurysm). CONCLUSIONS-: Two-phase 64-slice CCTA is a noninvasive and useful modality for detecting high-risk cardiac sources of embolism in stroke patients.
AB - BACKGROUND AND PURPOSE-: We assessed the diagnostic performance of 2-phase 64-slice cardiac computed tomographic angiography (CCTA) for the detection of a cardiac source of embolism in stroke patients using transesophageal echocardiography (TEE) as the reference standard. METHODS-: We selected 137 patients who had experienced a recent episode of stroke and had undergone both 2-phase 64-slice CCTA and TEE within a period of 5 days. A potential cardiac source of embolism detected at both CCTA and TEE was recorded, and echocardiographic findings were categorized into high- and medium-risk sources based on the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification. RESULTS-: Of 137 patients, 100 abnormal findings in 91 patients were found on TEE, and 46 patients had no abnormal finding on TEE. The overall sensitivity, specificity, positive predictive value, and negative predictive value of the 64-slice CCTA for detecting cardiac sources of embolism were 89% (95% CI, 82%, 95%), 100% (95% CI, 90%, 100%), 100% (95% CI, 95%, 100%), and 81% (95% CI, 70%, 92%), respectively. TEE detected a total of 47 high-risk sources of embolism, whereas CT detected 44 lesions. For medium-risk sources of cardiac embolic stroke, TEE detected a total of 53 abnormal findings, whereas CT detected 44 abnormal findings. Of 53 lesions, there were 8 false-negative results on CT (5 patent foramen ovale and 3 atrial septal aneurysm). CONCLUSIONS-: Two-phase 64-slice CCTA is a noninvasive and useful modality for detecting high-risk cardiac sources of embolism in stroke patients.
UR - http://www.scopus.com/inward/record.url?scp=66849122589&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=66849122589&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.108.537928
DO - 10.1161/STROKEAHA.108.537928
M3 - Article
C2 - 19372451
AN - SCOPUS:66849122589
VL - 40
SP - 2073
EP - 2078
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 6
ER -