Optimal slice thickness of brain computed tomography using a hybrid iterative reconstruction algorithm for identifying h
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ORIGINAL ARTICLE
Optimal slice thickness of brain computed tomography using a hybrid iterative reconstruction algorithm for identifying hyperdense middle cerebral artery sign of acute ischemic stroke Shota Ichikawa 1
&
Misaki Hamada 1 & Daiki Watanabe 1 & Osamu Ito 1 & Takafumi Moriya 1 & Hiroyuki Yamamoto 1
Received: 15 August 2020 / Accepted: 9 October 2020 # American Society of Emergency Radiology 2020
Abstract Purpose To determine the optimal slice thickness of brain non-contrast computed tomography using a hybrid iterative reconstruction algorithm to identify hyperdense middle cerebral artery sign in patients with acute ischemic stroke. Methods We retrospectively enrolled 30 patients who had presented hyperdense middle cerebral artery sign and 30 patients who showed no acute ischemic change in acute magnetic resonance imaging. Reformatted axial images at an angle of the orbitomeatal line in slice thicknesses of 0.5, 1, 3, 5, and 7 mm were generated. Optimal slice thickness for identifying hyperdense middle cerebral artery sign was evaluated by a receiver operating characteristics curve analysis and area under the curve (AUC). Results The mean AUC value of 0.5-mm slice (0.921; 95% confidence interval (95% CI), 0.868 to 0.975) was significantly higher than those of 3-mm (0.791; 95% CI, 0.686 to 0.895; p = 0.041), 5-mm (0.691; 95% CI, 0.583 to 0.799, p < 0.001), and 7mm (0.695; 95% CI, 0.593 to 0.797, p < 0.001) slices, whereas it was equivalent to that of 1-mm slice (0.901; 95% CI, 0.837 to 0.965, p = 0.751). Conclusion Thin slice thickness of ≤ 1 mm has a better diagnostic performance for identifying hyperdense artery sign on brain non-contrast computed tomography with a hybrid iterative reconstruction algorithm in patients with acute ischemic stroke. Keywords Computed tomography . Hyperdense artery sign . Acute ischemic stroke . Slice thickness . Hybrid iterative reconstruction algorithm
Introduction
* Shota Ichikawa [email protected] Misaki Hamada [email protected] Daiki Watanabe [email protected] Osamu Ito [email protected] Takafumi Moriya [email protected] Hiroyuki Yamamoto [email protected] 1
Department of Radiological Technology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan
Non-contrast computed tomography (NCCT) of the brain is the first-line diagnostic examination for the evaluation of acute ischemic stroke. This is mainly due to its wide availability, time efficiency, and higher sensitivity for cerebral hemorrhage. Hyperattenuation of a cerebral artery compared with adjacent or equivalent contralateral vessels on NCCT, or hyperdense artery sign, is a well-known early sign of brain ischemic stroke [1, 2]. This finding is thought to represent acute intraluminal thrombi that can be observed most frequently in the middle cerebral artery [3]. The hyperdense artery sign has been described as having a high specificity (90 to 100%) and a very low sensitivity (about 30% to 50%) [4, 5]. This insufficient sensitivity is due to the large slice thic
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