Heart-to-Brain Multiphasic CT Angiography and Cardiac Screening in Acute Ischemic Stroke—Technical Concepts for CT Cardiac Studies in Stroke Patients

M. Nedunchelian, Gayathri Priyadharshinee, K. M. Athiyappan, Pudhiavan Arunachalam, M. Cherian, R. Iyer, S. Elumalai, S. Varadharajan
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Abstract

Cardiac CT studies to detect embolic sources can be a useful supplement to the imaging armamentarium of acute stroke patients and we explore its possibilities in 2 distinct populations in this technical note. Prior literature has looked at the yield of covering the heart during CT angiography (CTA) in addition to echocardiography and found that it can increase the detection rate of occult embolic sources such as mural thrombus, tumors, and infarcts. The advent of multiphasic CTA for acute stroke patients as part of vascular imaging prior to EVT selection has increased the likelihood of extending coverage or specifically screening the heart in such patients. Additionally, patterns of infarcts and imaging signs can help focus selective patients for dedicated cardiac screening, especially after initial negative echocardiography. We describe the technical aspects of cardiac CT screening in acute stroke patients in this brief report. Future studies in these specific cohorts can confirm the increased yield for early anticoagulation and address modifications for optimal balance with regard to additional radiation exposure.
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急性缺血性卒中心脑多期CT血管造影和心脏筛查——卒中患者CT心脏研究的技术概念
心脏CT研究检测栓塞源是对急性中风患者成像设备的有用补充,我们在这篇技术笔记中探讨了它在2个不同人群中的可能性。之前的文献研究了CT血管造影(CTA)和超声心动图中覆盖心脏的量,发现它可以提高对壁上血栓、肿瘤和梗死等隐性栓塞源的检出率。多期CTA作为EVT选择前血管成像的一部分用于急性卒中患者,增加了扩大覆盖范围或专门筛查此类患者心脏的可能性。此外,梗塞的模式和影像学征象可以帮助集中选择性患者进行专门的心脏筛查,特别是在初始超声心动图阴性后。在这篇简短的报告中,我们描述了急性中风患者心脏CT筛查的技术方面。在这些特定队列中的未来研究可以证实早期抗凝治疗的增加,并解决关于额外辐射暴露的最佳平衡的修改。
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