Free-Breathing, Non-Gated Heart-To-Brain CTA in Acute Ischemic Stroke: A Feasibility Study on Dual-Source CT

PurposeTo validate the feasibility of free-breathing, non-gated, high-pitch heart-to-brain computed tomography arteriography (CTA) in acute ischemic stroke and the capability of non-gated heart-to-brain CTA in showing cardiac anatomy. Materials and MethodsThe study protocol was approved by the institutional medical ethics review board. Free-breathing, non-gated, high-pitch heart-to-brain CTA was performed on patients with acute ischemic stroke referred for multimodal CT using a third-generation dual-source CT. Patients scheduled for ECG-triggered heart-to-brain CTA served as controls. Quantitative and/or qualitative image quality of the four cardiac chambers, left atrial appendage, interventricular and interatrial septa, carotid arteries, and coronary arteries were evaluated and compared between the two groups. ResultsFree-breathing, non-gated, high-pitch heart-to-brain CTA was performed on 30 patients with acute ischemic stroke, whereas the control group included 31 cases. There is no significant difference in the image quality of CTAs between the two groups at cardiac chambers and carotid arteries. The image quality of coronary arteries also showed no significant difference between the two groups. The mean dose length products of CTA in the two groups were 129.1 +/- 30.5 mGy cm and 121.6 +/- 30.3 mGy cm, respectively. Cardiac abnormality can be shown in patients with acute ischemic stroke. ConclusionIt is feasible to use free-breathing, non-gated, high-pitch heart-to-brain CTA with dual-source CT in acute ischemic stroke for cardiac etiology screening.

Automated summary

This study validated the feasibility of using free-breathing, non-gated, high-pitch heart-to-brain CTA in acute ischemic stroke and its ability to show cardiac anatomy. The image quality of CTAs in the heart chambers, carotid arteries, and coronary arteries showed no significant difference between the free-breathing group and the ECG-triggered group. The dose length products of the two groups were also similar. Therefore, free-breathing, non-gated, high-pitch heart-to-brain CTA can be used as an effective method for screening cardiac etiology in acute ischemic stroke patients.