Department of Neuroradiology, University Medicine Goettingen, Goettingen, Germany.
Department of Neurology, University Medicine Goettingen, Goettingen, Germany.
J Neurointerv Surg. 2017 Dec;9(12):1253-1257. doi: 10.1136/neurintsurg-2016-012866. Epub 2016 Dec 20.
Flat detector CT (FDCT) has been used as a peri-interventional diagnostic tool in numerous studies with mixed results regarding image quality and detection of intracranial lesions. We compared the diagnostic aspects of the latest generation FDCT with standard multidetector CT (MDCT).
102 patients were included in our retrospective study. All patients had undergone interventional procedures. FDCT was acquired peri-interventionally and compared with postinterventional MDCT regarding depiction of ventricular/subarachnoidal spaces, detection of intracranial hemorrhage, and delineation of ischemic lesions using an ordinal scale. Ischemic lesions were quantified with the Alberta Stroke Program Early CT Scale (ASPECTS) on both examinations. Two neuroradiologists with varying grades of experience and a medical student scored the anonymized images separately, blinded to the clinical history.
The two methods were of equal diagnostic value regarding evaluation of the ventricular system and the subarachnoidal spaces. Subarachnoidal, intraventricular, and parenchymal hemorrhages were detected with a sensitivity of 95%, 97%, and 100% and specificity of 97%, 100%, and 99%, respectively, using FDCT. Gray-white differentiation was feasible in the majority of FDCT scans, and ischemic lesions were detected with a sensitivity of 71% on FDCT, compared with MDCT scans. The mean difference in ASPECTS values on FDCT and MDCT was 0.5 points (95% CI 0.12 to 0.88).
The latest generation of FDCT is a reliable and accurate tool for the detection of intracranial hemorrhage. Gray-white differentiation is feasible in the supratentorial region.
平板探测器 CT（FDCT）已在多项研究中作为介入治疗期间的诊断工具使用，其图像质量和颅内病变检测的结果存在差异。我们比较了最新一代 FDCT 与标准多层 CT（MDCT）的诊断性能。
我们对 102 例接受介入治疗的患者进行了回顾性研究。FDCT 在介入治疗期间获得，并与介入后 MDCT 进行比较，比较内容包括脑室/蛛网膜下腔显示、颅内出血检测以及使用等级量表对缺血性病变的勾画。在两次检查中均使用 Alberta 卒中项目早期 CT 评分（ASPECTS）对缺血性病变进行定量评估。两名经验程度不同的神经放射科医生和一名医学生对匿名图像进行了独立评分，对患者的临床病史不知情。
在评估脑室系统和蛛网膜下腔方面，两种方法的诊断价值相当。FDCT 检测蛛网膜下腔、脑室内和实质内出血的敏感性分别为 95%、97%和 100%，特异性分别为 97%、100%和 99%。FDCT 能够在大多数扫描中实现灰白质区分，其检测缺血性病变的敏感性为 71%，与 MDCT 扫描相当。FDCT 和 MDCT 的 ASPECTS 值的平均差异为 0.5 分（95%CI 0.12 至 0.88）。
最新一代 FDCT 是一种可靠且准确的颅内出血检测工具。在幕上区域能够实现灰白质区分。
