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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Utility of Repeat Cerebrovascular Imaging among Hospitalized Stroke Patients
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Utility of Repeat Cerebrovascular Imaging among Hospitalized Stroke Patients

机译：住院脑卒中患者重复脑血管血管成像的效用

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Background and Purpose: The purpose of this study is to evaluate the frequency and clinical utility of repeat cerebrovascular imaging with computed tomography angiography (CTA) of the head after contrast-enhanced magnetic resonance angiography (CE-MRA) of the head in acute stroke patients. Materials and Methods: All stroke patients admitted to 2 academic medical centers from January 1, 2012 through December 31, 2014 were identified as part of prospective radiology database if they underwent CE-MRA of the head followed by subsequent CTA of the head within 7 days. Two vascular neurologists blinded to CTA results retrospectively reviewed medical records including documented indications for imaging studies and clinical changes in patients to determine necessity of CTA. Results: Of 1355 acute stroke patients who underwent CE-MRA of the head, 195 (14%) patients underwent subsequent CTA of the head within 7 days, including 33 patients with nondiagnostic CE-MRA because of motion artifact. Of the remaining 162 (12%) patients, 69 (43%) were considered to have an unnecessary CTA of the head. Multivariable logistic regression analysis identified (1) absence of new neurologic examination changes [OR 7.29; 95% CI 1.92-27.63] and (2) same documented indication for both studies [OR 6.47; 95% CI 3.04-13.78] as significant predictors of an unnecessary CTA. Changes in clinical management after CTA were significantly more common in necessary CTAs compared with studies determined to be unnecessary (42% versus 7%, P < .0001). Conclusion: The utility of repeat cerebrovascular imaging with CTA of the head following a diagnostic CE-MRA is low when there is no change in neurologic examination or when ordered for the same indication.
机译：背景和目的：本研究的目的是评估急性中风患者头部对比增强磁共振血管造影（CE-MRA）后头部对头部的计算机断层血管血管造影（CTA）的频率和临床效用。材料和方法：从2012年1月1日至2012年12月31日录取了2个学术医疗中心的所有中风患者被确定为预期放射科数据库的一部分，如果他们接受了头部的CE-MRA，然后在7天内接下来的CTA。 。两位血管神经学家对CTA的结果回顾性地审查了医疗记录，包括记录的成像研究和患者临床变化来确定CTA的必要性。结果：1355例急性中风患者患者接受了头部的CE-MRA，195例（14％）患者在7天内接受了后续CTA的患者，其中包括33例患者因运动伪影。剩余的162例（12％）患者中，69例（43％）被认为是头部不必要的CTA。鉴定多变量逻辑回归分析（1）缺乏新的神经检查变化[或7.29; 95％CI 1.92-27.63]和（2）研究的相同记录迹象[或6.47; 95％CI 3.04-13.78]作为不必要的CTA的重要预测因子。 CTA后CTA后临床管理的变化在必要的CTA方面具有明显常见的与确定不需要的研究相比（42％对7％，P <.0001）。结论：在诊断CE-MRA诊断CE-MRA后对头部CTA对脑血管血管成像的效用低，因为神经检查没有变化或命令相同的指示。

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