Sensitivity of Computed Tomography and Serial Scintigraphy in Cerebrovascular Disease

Buell, Udalrich; Kazner, E.; Rath, M; Steinhoff, H.; Kleinhans, E.; Lanksch, W.

doi:10.1148/131.2.393

Cited by 24 publications

(11 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…33 - 35 MRI offers more sophisticated methods than CT for characterizing cerebrovascular lesions. 36 However, MRI has its pitfalls 32 (e.g., in visualizing bleeding) and is not as widely available as CT.…”

mentioning

confidence: 99%

Correlation of clinical and computed tomographic findings in stroke patients.

Sotaniemi

Pyhtinen

Myllylä

1990

Stroke

View full text Add to dashboard Cite

T he introduction of computed tomography (CT) to clinical practice has had a great impact on our knowledge of cerebrovascular disorders, and cerebral CT has become the most commonly used primary radiologic investigation for stroke.1 " 3 Cerebral CT has shown that the prognosis of intracerebral hemorrhage (ICH) is not as poor as was supposed when small hemorrhages were often undiagnosed or misdiagnosed as ischemic events,and it has changed the order of diagnostic procedures for stroke. Furthermore, in differentiating ischemic infarcts from hemorrhagic lesions, 1 -36 ' 7 cerebral CT has proved to be of crucial importance for therapeutic considerations, particularly anticoagulant treatment.Despite a vast number of CT studies devoted to cerebrovascular disorders, the available knowledge on clinical and CT correlations in stroke is based on highly selected patient samples 8 -14 and little is known of the findings in routine neurologic patients. To elucidate these correlations, we prospectively studied all 1,191 neurologic patients referred for cerebral CT during 1 year in a neurological department. The relation between clinical and CT findings was assessed at two phases, first, after the neurologic eval- Received November 16, 1988; accepted July 11, 1990. uation made on admission and following the first CT investigation and, second, after the final diagnosis was made based on all available information. Subjects and MethodsDuring the year under survey, 1,191 neurologic patients were referred for cerebral CT. This hospitalbased patient sample comprised 572 men and 619 women aged 15-87 (mean 46) years. Cerebrovascular etiology of central nervous system (CNS) symptoms and signs was suggested clinically in 386 patients (32.4%). The patient sample included all those in whom ICH, subarachnoid hemorrhage (SAH), subdural hematoma, or cerebral infarction were suspected and virtually all those with suggested transient ischemic attack (TIA). Generally accepted diagnostic criteria 15 were used.The CT study was ordered only after recommendation by a neurologist who defined and registered the clinical data and suspected localization of the lesion. The radiologist determined the CT diagnosis. The final diagnosis was based on all the clinical, radiologic, electroencephalographic, neurosurgical, neuropathologic, and ancillary information accumulated. In addition to the 386 patients in whom CT was performed because of a suspected cerebrovascular disorder, 805 patients in whom cerebrovascular disease had not been initially suspected but in whom CT and/or the ancillary investigations revealed cerebrovascular pathology were also analyzed.

show abstract

mentioning

confidence: 99%

Correlation of clinical and computed tomographic findings in stroke patients.

Sotaniemi

Pyhtinen

Myllylä

1990

Stroke

View full text Add to dashboard Cite

show abstract

“…Scans were evaluated according to published criteria. 2 ' •"" Tumors, abscesses, congenital and posttraumatic lesions were excluded by history, clinical status, T-CAT appearance and experience. T-CAT evaluation was used to define whether a patient had VOL 12 regions of altered density corresponding to intracerebral vascular disease ("true positives") in the clinically affected hemisphere.…”

Section: Methodsmentioning

confidence: 99%

Sensitivity of computer assisted radionuclide angiography in transient ischemic attack and prolonged reversible ischemic neurological deficit. Comparison with findings in radiographic angiography and transmission computerized axial tomography.

Buell¹,

Scheid²,

Lanksch³

et al. 1981

Stroke

View full text Add to dashboard Cite

SUMMARY Computer assisted radionuclide angiography (CARNA) with "Tc-DTPA was employed to study 143 patients with transient lscbemic attacks (TIA) and 79 patients with prolonged reversible ischemic neurologic deficit (PRIND). The results of CARNA were compared with findings from radiographic angiography (RGA) in 173 patients and with findings in transmission computerized axial tomography (T-CAT) in 154 patients. In patients with TIA, CARNA showed a hemispherical perfusion deficit in 74.8%, and with PRIND 873%. This deficit, determined as the relative difference between the involved and the non-involved hemisphere, was significantly (p < 0.0025) greater In PRIND (minus 23%) than in TIA (minus 17%). Sensitivity of CARNA was independent of the interval from ictus to examination for more than 4 months. RGA in TLA revealed true positives in 82.0%, in PRIND it was 89.5%. T-CAT was positive in TIA in only 16.8% but in PRIND it was 64.4%. Combined sensitivities in TIA (92.4%) and in PRIND (94.0%) were highest with the combination of CARNA and RGA. However, in PRIND the combination of non-invasive methods (CARNA and T-CAT) revealed 93.2% positive findings. Combinations of these evaluation methods may be used to detect cerebrovascular disease in patients with such dysfunction. Stroke, Vol 12, No 6, 1981 RADIONUCLIDE angiography (RNA) with T cpertechnetate or wm Tc-DTPA is the first component of cerebral serial scintigraphy (CSS) and the second is static imaging. CSS yields useful results in both the detection and identification of intra-cranial tumors 1 as well as in the detection and localization of cranial vascular disease.1 Intra-cranial vascular disease in static nuclear images is reflected by intra-cranial accumulation of T c at the site of a disrupted blood brain barrier. Since such accumulation occurs mainly in completed stroke, less severe changes of intra-cerebral perfusion may be detected exclusively by employing RNA, evaluated either by visual Computer assisted radionuclide angiography (CARNA) was employed in patients with transient ischemic attacks (TIA) or prolonged reversible ischemic neurologic deficit (PRIND) to establish the sensitivity of CARNA in detecting and quantifying changes of cerebral perfusion. Results of CARNA were compared with findings from transmission computerized axial tomography (T-CAT) and with findings from cranial radiographic angiography (RGA) to obtain data on the combined sensitivities of these methods.From the Departments of Radiology, Neurosurgery, and Neurology, University of Munich, Klinikum Grosshadern, Munich, Federal Republic of Germany.Reprints: Dr. Buell, Dept. Radiology, University of Munich, Klinikum Grosshadern, 8000 Munich 70, Federal Republic of Germany. Material and MethodsA total of 222 patients were studied. Of these, 143 had TIA and 79 had PRIND. The patients were further divided according to the interval of time which had elapsed between ictus and examination. Patients included in the present study were not initially examined to compare results of CARNA, T-CAT a...

show abstract

“…57,209,210,[213][214][215][216][217][218] Only six studies (3001 patients, 40% of studies) were blinded to clinical history 211,219 or clinical history and other imaging. 215,217,220,221 The gold 57,[210][211][212][213][214]216,[218][219][220]222 follow-up scan in two studies (83 patients, 13% of studies), 221,223 and undefined in three studies (1233 patients, 20% of studies).…”

Section: Ct Studies Of Cerebral Infarctionmentioning

confidence: 99%

“…215,217,220,221 The gold 57,[210][211][212][213][214]216,[218][219][220]222 follow-up scan in two studies (83 patients, 13% of studies), 221,223 and undefined in three studies (1233 patients, 20% of studies). 209,215,217 …”

Section: Ct Studies Of Cerebral Infarctionmentioning

confidence: 99%

What is the best imaging strategy for acute stroke?

Wardlaw

Keir

Seymour

et al. 2005

Int J Technol Assess Health Care

View full text Add to dashboard Cite

Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTAWhat is the best imaging strategy for acute stroke? NHS R&D HTA ProgrammeT he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS.Initially, six HTA panels (pharmaceuticals, acute sector, primary and community care, diagnostics and imaging, population screening, methodology) helped to set the research priorities for the HTA Programme. However, during the past few years there have been a number of changes in and around NHS R&D, such as the establishment of the National Institute for Clinical Excellence (NICE) and the creation of three new research programmes: Service Delivery and Organisation (SDO); New and Emerging Applications of Technology (NEAT); and the Methodology Programme.This has meant that the HTA panels can now focus more explicitly on health technologies ('health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care) rather than settings of care. Therefore the panel structure was replaced in 2000 by three new panels: Pharmaceuticals; Therapeutic Procedures (including devices and operations); and Diagnostic Technologies and Screening.The HTA Programme will continue to commission both primary and secondary research. The HTA Commissioning Board, supported by the National Coordinat...

show abstract

Sensitivity of Computed Tomography and Serial Scintigraphy in Cerebrovascular Disease

Cited by 24 publications

References 16 publications

Correlation of clinical and computed tomographic findings in stroke patients.

Correlation of clinical and computed tomographic findings in stroke patients.

Sensitivity of computer assisted radionuclide angiography in transient ischemic attack and prolonged reversible ischemic neurological deficit. Comparison with findings in radiographic angiography and transmission computerized axial tomography.

What is the best imaging strategy for acute stroke?

Contact Info

Product

Resources

About