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Brain computed tomography using iterative reconstruction to diagnose acute middle cerebral artery stroke: usefulness in combination of narrow window setting and thin slice reconstruction

  • Diagnostic Neuroradiology
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Abstract

Purpose

The purpose of this study is to determine whether iterative model reconstruction (IMR) optimized for brain CT could improve the detection of acute stroke in the setting of thin image slices and narrow window settings.

Methods

We retrospectively reviewed 27 patients who presented acute middle cerebral artery (MCA) stroke. Images were reconstructed using filtered back projection (FBP; 1- and 5-mm slice thickness) and IMR (1 mm thickness), and contrast-to-noise ratios (CNRs) of infarcted and non-infarcted areas were compared. To analyze the performance of acute MCA stroke detection, we used receiver operating characteristic (ROC) curve techniques and compared 5-mm FBP with standard and narrow window settings, and 1-mm FBP and IMR with narrow window settings.

Results

The CNR in 1-mm IMR (1.1 ± 1.0) was significantly higher than in 5- (0.8 ± 0.7) and 1-mm FBP (0.4 ± 0.4) (p < 0.001). Furthermore, the average area under the ROC curve was significantly higher with 1-mm IMR with narrow window settings (0.90, 95% CI: 0.86, 0.94) than it was with 5-mm FBP (0.78, 95% CI: 0.72, 0.83).

Conclusion

The combination of thin image slices and narrow window settings under IMR reconstruction provide better diagnostic performance for acute MCA stroke than conventional reconstruction methods.

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Authors and Affiliations

  1. Department of Radiology, Amakusa Medical Center, 854-1 Jikiba, Amakusa, Kumamoto, Japan

    Taihei Inoue, Morikatsu Yoshida & Koichi Yokoyama

  2. Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan

    Takeshi Nakaura, Hiroyuki Uetani, Seitaro Oda, Daisuke Utsunomiya, Mika Kitajima & Yasuyuki Yamashita

  3. Department of Surgery, Amakusa Medical Center, Kumamoto, Japan

    Kazunori Harada

Authors
  1. Taihei Inoue
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  2. Takeshi Nakaura
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  3. Morikatsu Yoshida
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  4. Koichi Yokoyama
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  5. Hiroyuki Uetani
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  7. Daisuke Utsunomiya
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  8. Mika Kitajima
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  10. Yasuyuki Yamashita
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Corresponding author

Correspondence to Taihei Inoue.

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No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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For this type of study formal consent is not required.

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Inoue, T., Nakaura, T., Yoshida, M. et al. Brain computed tomography using iterative reconstruction to diagnose acute middle cerebral artery stroke: usefulness in combination of narrow window setting and thin slice reconstruction. Neuroradiology 60, 373–379 (2018). https://doi.org/10.1007/s00234-018-1982-8

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  • DOI: https://doi.org/10.1007/s00234-018-1982-8

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