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多模态CT检查在疑似中风诊断中的重要性:前瞻性观察性多中心研究设计

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

作者信息

Dvorníková Kateřina, Kunešová Veronika, Ely Marcela, Ostrý Svatopluk, Čábal Martin, Reiser Martin, Machová Linda, Pavlínová Markéta, Kondé Adéla, Eliáš Pavel, Jonszta Tomáš, Havelka Jaroslav, Volný Ondrej, Bar Michal

机构信息

Department of Neurology, University Hospital Ostrava, Ostrava, Czechia.

Department of Imaging Methods, Faculty of Medicine, Ostrava of University, Ostrava, Czechia.

出版信息

Front Neurol. 2024 Jun 4;15:1365986. doi: 10.3389/fneur.2024.1365986. eCollection 2024.

Abstract

INTRODUCTION

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.

AIM

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.

METHODOLOGY

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.

CONCLUSION

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.

CLINICAL TRIAL REGISTRATION

clinicaltrials.gov, NCT06045455.

摘要

引言

对于疑似中风病例,非增强计算机断层扫描(CT)和CT血管造影是神经影像诊断的金标准。CT灌注(CTP)在疑似中风(SM)的诊断中可能发挥重要作用,但目前它并非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性临床研究,专注于优化医院护理中中风和疑似中风(SM)的诊断。

目的

本研究旨在评估多模态CT(非增强CT、CT血管造影和CTP)在诊断疑似中风与中风方面的特异性和敏感性程度。

方法

在本研究中,我们将纳入3000例连续入住综合中风中心且诊断为疑似中风的患者。根据临床参数以及多模态CT和磁共振成像(MRI)的结果,确定中风和疑似中风的诊断。为阐明使用多模态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,以及对入组患者的初始诊断和最终诊断进行比较。根据我们的结果,我们将比较经济指标以及因不对疑似中风患者进行不适当治疗而节省的成本。

结论

预期结果是提出一种优化的诊断程序,从而实现更快、更准确的诊断,进而消除疑似中风患者接受不适当治疗的风险。

临床试验注册

clinicaltrials.gov,NCT06045455。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18b4/11184135/e71596bc5e02/fneur-15-1365986-g001.jpg

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