Deipolyi A R, Hamberg L M, Gonzaléz R G, Hirsch J A, Hunter G J
From the Department of Radiology (A.R.D., R.G.G., J.A.H., G.J.H.), Massachusetts General Hospital, Boston, Massachusetts.
Department of Radiology (L.M.H.), Brigham and Women's Hospital, Boston, Massachusetts.
AJNR Am J Neuroradiol. 2015 Feb;36(2):265-8. doi: 10.3174/ajnr.A4112. Epub 2014 Sep 25.
Our aim was to investigate how often relevant diagnostic findings in an arch-to-vertex CTA scan, obtained specifically as part of the acute stroke CT protocol, are located in the head, neck, and upper chest regions.
Radiology reports were reviewed in 302 consecutive patients (170 men, 132 women; median ages, 66 and 73 years, respectively) who underwent emergency department investigation of suspected acute stroke between January and July 2010. Diagnostic CTA findings relevant to patient management were recorded for the head, neck, and chest regions individually. Additionally, the contributions to the total CTA scan effective dose were estimated from each of the 3 anatomic regions by using the ImPACT CT Dose Calculator.
Of the 302 patients, 161 (54%) had relevant diagnostic findings in the head; 94 (31%), in the neck; and 4 (1%), in the chest. The estimated contributions to the total CTA scan dose from each body region, head, neck, and upper chest, were 14 ± 2%, 33 ± 5%, and 53 ± 6%, respectively.
Most clinically relevant findings are in the head and neck, supporting inclusion of these regions in arch-to-vertex CTA performed specifically in patients with acute stroke in the emergency department. Further studies are required to investigate extending the scan to the upper chest because only 1% of patients in our study had clinically relevant findings in the mediastinum, yet half the CTA effective dose was due to scanning in this region.
我们的目的是研究在专门作为急性卒中CT检查方案一部分而进行的全主动脉弓至颅顶CT血管造影（CTA）扫描中，相关诊断性发现位于头部、颈部和上胸部区域的频率。
回顾了2010年1月至7月期间因疑似急性卒中在急诊科接受检查的302例连续患者（170例男性，132例女性；年龄中位数分别为66岁和73岁）的放射学报告。分别记录头部、颈部和胸部区域与患者管理相关的CTA诊断性发现。此外，使用ImPACT CT剂量计算器从三个解剖区域中的每一个区域估算对CTA扫描有效剂量的贡献。
在302例患者中，161例（54%）在头部有相关诊断性发现；94例（31%）在颈部；4例（1%）在胸部。头部、颈部和上胸部每个身体区域对CTA扫描总剂量的估计贡献分别为14±2%、33±5%和53±6%。
大多数临床相关发现位于头部和颈部，这支持在急诊科对急性卒中患者进行的全主动脉弓至颅顶CTA检查中纳入这些区域。需要进一步研究以探讨将扫描范围扩展至上胸部，因为在我们的研究中只有1%的患者在纵隔有临床相关发现，然而CTA有效剂量的一半是由于该区域的扫描。
