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01-12-2018 | Diagnostic Neuroradiology

“Hyperdense artery sign” in early ischemic stroke: diagnostic value of model-based reconstruction approach in comparison with standard hybrid iterative reconstruction algorithm

Authors: Sophie Lombardi, Luca Riva, Mirko Patassini, Paolo Remida, Cristina Capraro, Francesco Canonico, Cammillo Talei Franzesi, Davide Ippolito

Published in: Neuroradiology | Issue 12/2018

Abstract

Purpose

Hyperdense artery sign is the earliest sign of ischemic stroke on non-enhanced computed tomography and it can be visible long before parenchymal changes. The aim of our study was to compare diagnostic value of model-based iterative reconstruction algorithm (IMR) with that of iterative reconstruction algorithm (iDose4) in identifying hyperdense artery sign.

Methods

We selected 56 consecutive patients suspected for ischemic stroke, who underwent a NCCT and that demonstrated a vessel occlusion at angio-CT or developed ischemic lesion at follow-up CT. Two readers randomly analyzed images of NCCT reconstructed both with iDose4 (4 mm) and IMR (2 mm), reporting presence of hyperdense artery sign (0: no; 1: yes; 2: not sure). They rated image quality on a 4-point scale (1: unacceptable; 4: more than average) and recorded HU values of clot and of normal vessel and measured noise index, CNR and SNR.

Results

Mean values of CTDI, DLP, and ED were respectively of 43 mGy, 819.7 mGy cm, and 1.72 mSv.

By analyzing the IMR reconstruction, both readers were able to recognize hyperdense vessel sign in 55/56 patients, while only in 12/56 patients were identified with iDose.

IMR obtained better rating of image quality (mean score for IMR 3.32 vs 2.53 for iDose), higher clot density (57.2 vs 46.7 HU), lower noise index (5 vs 2), higher CNR and SNR (respectively 4.2 vs 2 and 16.8 vs 8.5).

Conclusions

Model-based approach significantly increases sensitivity in detecting hyperdense artery sign, offering higher SNR and CNR in brain CT images in comparison with standard hybrid reconstruction algorithm.

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Title: “Hyperdense artery sign” in early ischemic stroke: diagnostic value of model-based reconstruction approach in comparison with standard hybrid iterative reconstruction algorithm
Authors: Sophie Lombardi
Luca Riva
Mirko Patassini
Paolo Remida
Cristina Capraro
Francesco Canonico
Cammillo Talei Franzesi
Davide Ippolito
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 12/2018
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-018-2092-3

At a glance: The STEP trials

Springer Medicine

“Hyperdense artery sign” in early ischemic stroke: diagnostic value of model-based reconstruction approach in comparison with standard hybrid iterative reconstruction algorithm

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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