Keywords:
Dosimetry, Thrombolysis, Decision analysis, CT-High Resolution, CT-Angiography, CT, Radioprotection / Radiation dose, Neuroradiology brain, Interventional vascular, Acute, Obstruction / Occlusion, Ischaemia / Infarction
Authors:
N. J. Darcy1, S. Rienecker2, J. Blazak1; 1QLD/AU, 2Sunshine Coast/AU
DOI:
10.26044/ranzcr2019/R-0015
Results
124 stroke protocols were completed in the five-month period. Three studies were excluded as their data sets were incomplete. Two patients with hypoperfusion syndrome due to long standing anterior circulation disease were not considered to be thrombolysis or ECR candidates. Of the 121 patients included in the audit, 66.2 % ended up with a final diagnosis of stroke, 11.6 % were suitable for thrombolysis and 9.9 % were clot retrieval candidates (Figure 1). One patient was considered a clot retrieval candidate that had a basilar stroke, although they did not meet the criteria of a large vessel occlusion in the anterior circulation. DEFUSE 3 showed an absolute increase in functional independence at 90 days of 28% for ECR candidates, as opposed to those managed conservatively (3). The EXTEND trial revealed a 6.7% absolute increase in rates of functional independence in patients treated with thrombolysis, in whom ECR was not indicated (1).
The benefit to the patients imaged in this cohort was calculated to be 0.78% secondary to eligibility for thrombolysis and 2.78% due to ECR. The combined benefit of both modalities for all patients was 3.6 %.
The average DLP and CTDI vol are recorded in Table 1. The effective dose estimates are included in Table 2. The average dose for men being 10.3mSv and for women 10.9mSv. Patients ages ranged from 20 to 93 with an average age of 67. The LAR for a female in her 20’s (the most radio-sensitive cohort) was calculated to be 1/1200 (Table 4 and Figure 2).