Comprehensive Analysis of Basal Ganglia Densities in Acute Middle Cerebral Artery Ischemia on Computed Tomography

Yıl 2022, Cilt: 3 Sayı: 1, 273 - 283, 07.04.2022

Erdal Komut , Seval Komut

Öz

Objective: To present a new objective radiological criterion that can detect early cerebral ischemia by analyzing the density changes in the basal ganglia, which are well-characterized anatomical structures in non-contrast brain tomography, in patients with acute ischemic stroke confirmed by diffusion-weighted magnetic resonance imaging.
Material and Method: Of the patients who underwent brain tomography and diffusion-weighted imaging due to a suspected acute ischemic stroke, those with normal tomography findings were included in the study. Ischemic cases were included in the acute ischemic stroke group, and those that were not diagnosed with ischemia were included in the control group. The densities of the thalamus and basal ganglia were measured in all patients.
Results: In the control group, the left basal ganglia and thalamus densities were higher compared to the right side. In the acute ischemic stroke group, the densities of the lentiform and caudate nucleus were significantly higher on the non-ischemia side than on the ischemia side. The acute ischemic stroke group had a lower symmetrical agreement in terms of the densities of the basal ganglia and thalamus compared to the control group.
Conclusion: In acute ischemic cases, density changes in the basal ganglia and thalamus are promising indicators that can be used in radiological diagnosis in the early period and at the time of non-contrast brain tomography.

Anahtar Kelimeler

stroke, tomography, emergency radiology

Kaynakça

• Lövblad K-O, Baird AE. Computed tomography in acute ischemic stroke. Neuroradiology. 2010;52(3):175-87.
• Jensen-Kondering U, Riedel C, Jansen O. Hyperdense artery sign on computed tomography in acute ischemic stroke. World J Radiol. 2010;2(9):354.
• Latchaw RE, Alberts MJ, Lev MH, et al. Recommendations for imaging of acute ischemic stroke: a scientific statement from the American Heart Association. Stroke. 2009;40(11):3646-78.
• Fiebach J, Schellinger P, Jansen O, et al. CT and diffusion-weighted MR imaging in randomized order: diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke. 2002;33(9):2206-10.
• Taşdemir N, Tamam Y, Tabak V, et al. A The Assessment of Early Stage Computed Tomography Findings in Acute Ischemic Stroke. Dicle Med J. 2008;35(1):50-7.
• Moulin T, Cattin F, Crepin-Leblond T, et al. Early CT signs in acute middle cerebral artery infarction: predictive value for subsequent infarct locations and outcome. Neurology. 1996;47(2):366-75.
• Olcay HÖ, Çevik Y, Emektar E. Evaluation of Radiological Imaging Findings and Affecting Factors in Patients with Acute Ischemic Stroke. Ankara Med J. 2018;18(4):492-9.
• National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasogen activator for acute ischemic stroke. N Engl J Med. 1995;333(24):1581-7.
• Teksam M, Cakir B, Coskun M. CT perfusion imaging in the early diagnosis of acute stroke. Diagn Interv Radiol. 2005;11(4):202.
• Mayer TE, Hamann GF, Baranczyk J, et al. Dynamic CT perfusion imaging of acute stroke. AJNR Am J Neuroradiol. 2000;21(8):1441-9.
• Wardlaw J. Overview of Cochrane thrombolysis meta-analysis. Neurology. 2001;57(suppl 2):S69-S76.
• Prokop M. Multislice CT angiography. Eur J Radiol. 2000;36(2):86-96.
• von Kummer R, Meyding-Lamade U, Forsting M, Rosin L, et al. Sensitivity and prognostic value of early CT in occlusion of the middle cerebral artery trunk. AJNR Am J Neuroradiol. 1994;15(1):9-15.
• Eastwood JD, Lev MH, Provenzale JM. Perfusion CT with iodinated contrast material. AJR Am J Roentgenol. 2003;180(1):3-12.
• Hegde AN, Mohan S, Lath N, et al. Differential diagnosis for bilateral abnormalities of the basal ganglia and thalamus. Radiographics. 2011;31(1):5-30.
• Osborn A. Diagnostic Neuroradiology. 1st Mosby-Year Book; 1994.
• Song P, Fang Z, Wang H, et al. Global and regional prevalence, burden, and risk factors for carotid atherosclerosis: a systematic review, meta-analysis, and modelling study. Lancet Glob Health. 2020;8(5):e721-e9.
• de Weerd M, Greving JP, de Jong AW, et al. Prevalence of asymptomatic carotid artery stenosis according to age and sex: systematic review and metaregression analysis. Stroke. 2009;40(4):1105-13.
• Cina C, Safar H, Maggisano R, et al. Prevalence and progression of internal carotid artery stenosis in patients with peripheral arterial occlusive disease. J Vasc Surg. 2002;36(1):75-82.