Diagnostic accuracy of large and medium vessel occlusions in acute stroke imaging by neurology residents and stroke fellows: A comparison of CT angiography alone and CT angiography with CT perfusion

Introduction: Neurology senior residents and stroke fellows are first to clinically assess and interpret imaging studies of patients presenting to the emergency department with acute stroke. The aim of this study was to compare the diagnostic accuracy of brain CT angiography (CTA) with and without C...

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Published in:European stroke journal 2024-06, Vol.9 (2), p.356-365
Main Authors: Alotaibi, Fawaz F, Alshahrani, Asma, Mohamed, Gamal, AlShamrani, Mohamed A, Bin Amir, Hussain, Alsaeed, Ali, Heji, Alaa, Alghanmi, Suwaidi, Alqurishi, Mohammed, Alanazi, Azhar, Aldraye, Hamad, Asiri, Muhannad, Alqahtani, Mohammed, Alreshaid, Abdulrahman A, AlKawi, Ammar, AlHazzani, Adel, AlZawahmah, Mohamed, Alokaili, Riyadh N, Shuaib, Ashfaq, Al-Ajlan, Fahad S
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Cerebral Angiography - methods
Computed Tomography Angiography - methods
Fellowships and Scholarships
Female
Humans
Internship and Residency
Male
Middle Aged
Neurology - education
Original s
Sensitivity and Specificity
Stroke - diagnostic imaging
Tomography, X-Ray Computed - methods
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Summary:Introduction: Neurology senior residents and stroke fellows are first to clinically assess and interpret imaging studies of patients presenting to the emergency department with acute stroke. The aim of this study was to compare the diagnostic accuracy of brain CT angiography (CTA) with and without CT perfusion (CTP) between neurology senior residents and stroke fellows. Methods: In this neuroimaging study, nine practitioners (four senior neurology residents (SNRs) and five stroke fellows (SFs)) clinically assessed and interpreted the imaging data of 50 cases (15 normal images, 21 large vessel occlusions (LVOs) and 14 medium vessel occlusions (MeVOs) in two sessions, 1 week apart in comparison to final diagnosis of experienced neuroradiologist and experienced stroke neurologist consensus. Interrater agreement of CTA alone and CTA with CTP was quantified using kappa statistics, sensitivity, specificity and overall accuracy. Results: Overall, arterial occlusions were correctly identified in 221/315 (70.1%) with CTA alone and in 266/315 (84.4%) with CTA and CTP (p 
ISSN:2396-9873
2396-9881
2396-9881
DOI:10.1177/23969873231214218