The importance of multimodal CT examination in stroke mimics diagnosis: design of prospective observational multicentre study

Kateřina Dvorníková, Veronika Kunešová, Marcela Ely, S. Ostrý, Martin Čábal, Martin Reiser, Linda Machová, Markéta Pavlínová, Adéla Kondé, Pavel Eliáš, Tomáš Jonszta, Jaroslav Havelka, O. Volny, Michal Bar
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Abstract

Non-contrast computed tomography (CT) and CT angiography are the gold standard in neuroimaging diagnostics in the case of suspected stroke. CT perfusion (CTP) may play an important role in the diagnosis of stroke mimics (SM), but currently, it is not a standard part of the stroke diagnostic procedure. The project is a multicentre prospective observational clinical research focused on refining the diagnostics of stroke and stroke mimics (SM) in hospital care.This study aimed to evaluate the degree of specificity and sensitivity of multimodal CT (NCCT, CTA, and CTP) in the diagnosis of SM versus stroke.In this study, we will include 3,000 patients consecutively admitted to the comprehensive stroke centres with a diagnosis of suspected stroke. On the basis of clinical parameters and the results of multimodal CT and magnetic resonance imaging (MRI), the diagnosis of stroke and SM will be established. To clarify the significance of the use of the multimodal CT scan, the analysis will include a comparison of the blinded results for each imaging scan performed by radiologists and AI technology and a comparison of the initial and final diagnosis of the enrolled patients. Based on our results, we will compare the economic indicators and costs that would be saved by not providing inadequate treatment to patients with SM.The expected outcome is to present an optimised diagnostic procedure that results in a faster and more accurate diagnosis, thereby eliminating the risk of inadequate treatment in patients with SM.clinicaltrials.gov, NCT06045455.
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多模态 CT 检查在中风模拟诊断中的重要性:前瞻性多中心观察研究的设计
非对比计算机断层扫描(CT)和 CT 血管造影是疑似脑卒中神经影像诊断的金标准。CT 灌注(CTP)可在中风拟态(SM)的诊断中发挥重要作用,但目前还不是中风诊断程序的标准组成部分。该项目是一项多中心前瞻性观察临床研究,重点在于完善医院护理中的卒中和卒中模拟物(SM)诊断。本研究旨在评估多模态 CT(NCCT、CTA 和 CTP)在诊断 SM 与卒中时的特异性和敏感性程度。在本研究中,我们将纳入 3000 名连续入住综合卒中中心并诊断为疑似卒中的患者。根据临床参数、多模态 CT 和磁共振成像(MRI)结果,确定卒中和 SM 的诊断。为了明确使用多模态 CT 扫描的意义,分析将包括对放射科医生和人工智能技术进行的每次成像扫描的盲法结果进行比较,以及对入选患者的初始诊断和最终诊断进行比较。根据我们的结果,我们将比较不对 SM 患者进行不适当治疗所节省的经济指标和成本。预期结果是提出一种优化的诊断程序,使诊断更快、更准确,从而消除 SM 患者接受不适当治疗的风险。
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