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01-04-2012 | Diagnostic Neuroradiology

Hyperdense basilar artery sign—a reliable sign of basilar artery occlusion

Authors: Lara Connell, Inga Katharina Koerte, Ruediger Paul Laubender, Dominik Morhard, Jennifer Linn, Hans Christoph Becker, Maximilian Reiser, Hartmut Brueckmann, Birgit Ertl-Wagner

Published in: Neuroradiology | Issue 4/2012

Abstract

Introduction

We aimed to investigate the value of the hyperdense basilar artery (HBA) sign and of basilar artery (BA) attenuation measurements as predictors of basilar artery occlusion (BAO) on nonenhanced cranial CT (NECT).

Methods

Forty-one consecutive patients with proven BAO in CT angiography, who had undergone NECT for initial evaluation (30 males, 11 females) were retrospectively included. Another 41 age-matched patients without BAO were included as a control group. The NECT scans of both groups were assessed by three independent blinded readers (staff, fellow, and resident) in a randomized reading order using a standardized semiquantitative questionnaire. Visual BA hyperdensity, including the presence of HBA sign (hyperdensity scores of 4 and 5/5), was assessed, quantitative BA attenuation was measured in a region of interest (ROI), and diagnosis of BAO was made before and after ROI measurements. For statistical analysis, multivariate mixed effects models, likelihood ratio tests, and receiver operating characteristics techniques were applied.

Results

HBA sign had a relatively low sensitivity (60.98–65.85%), specificity (70.73–90.24%), and accuracy (65.85–75.61%) for the presence/absence of BAO on NECT. Optimal cut-off points were 40–42 HU (sensitivity, 68.29–78.05%; specificity, 75.61–82.93%; accuracy, 74.39–80.49%).

Conclusion

In basilar artery occlusion, quantitative measurement of BA attenuation can slightly improve the diagnostic predictiveness of NECT. However, even with optimal cut-off values, the sensitivity is too low to serve as the sole diagnostic decision-making tool.

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Title: Hyperdense basilar artery sign—a reliable sign of basilar artery occlusion
Authors: Lara Connell
Inga Katharina Koerte
Ruediger Paul Laubender
Dominik Morhard
Jennifer Linn
Hans Christoph Becker
Maximilian Reiser
Hartmut Brueckmann
Birgit Ertl-Wagner
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 4/2012
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-011-0887-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hyperdense basilar artery sign—a reliable sign of basilar artery occlusion

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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