Keywords:
Ischaemia / Infarction, Comparative studies, Image manipulation / Reconstruction, CT, Head and neck, Emergency
Authors:
K. A. R. Balalta; Dasmarinas city/PH
DOI:
10.26044/ecr2019/C-2422
Aims and objectives
A non-contrast head CT scan is the standard radiologic test for patients presenting with stroke-like symptoms [1] in the emergency department,
due to its speed of imaging,
widespread availability and low cost.
The default window level in a cranial CT scan is around 40 Hounsfield units (HU),
with a window width of about 80 HU ("brain windows"); in our instution,
a window level of 40 HU and width of 100 HU is used. Increase in lesion conspicuity and improved accuracy of non-enhanced CT stroke detection may be achieved by the use of “stroke windows” - window level of 35 HU and width of 35 HU [2].
Fig. 1
This study aims to determine the diagnostic accuracy of using “stroke windows” among patients who underwent non-contrast head CT scan evaluation at the Department of Radiology,
De La Salle University Medical Center (DLSUMC),
Dasmarinas,
Cavite from January 2015 to December 2017.
Specifically,
this study aims to determine the prevalence of hyperacute infarction among patients presenting with stroke-like symptoms and underwent non-contrast head CT scan evaluation at the DLSUMC from January 2015 to December 2017,
the demographic characteristics of these patients,
and to determine the sensitivity and specificity of hyperacute infarction detection using “stroke windows” versus standard "brain windows" settings.
This has important implications in the early diagnosis and treatment of patients with early ischemic changes,
as thrombolytic therapy,
when elected,
needs to be given within the "golden period" - the first 3-6 hours after onset of symptoms [3].