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Hyperdense middle cerebral artery sign in multidetector computed tomography: Definition, occurrence, and reliability analysis.

Abul-Kasim, Kasim LU ; Selariu, Eufrozina LU ; Brizzi, Marco LU and Petersson, Jesper LU (2009) In Neurology India 57(2). p.143-150
Abstract
Background: The hyperdense middle cerebral artery sign (HMCAS) is one of the early changes seen on the computed tomography in acute ischemic stroke of MCA territory. Aims: To evaluate the reliability of subjective evaluation of HMCAS on CT performed at multidetector CT (MDCT) and evaluated in the Picture Archiving Communication Systems, to define objective criteria for HMCAS and to find out if there are any predictors for the occurrence of HMCAS. Materials and Methods: CTs of 121 consecutive patients (mean age of 70 years) treated with thrombolytic therapy were retrospectively evaluated by two neuroradiologists both subjectively and objectively with respect to HMCAS. Results: HMCAS was subjectively found in 32% of study population. The... (More)
Background: The hyperdense middle cerebral artery sign (HMCAS) is one of the early changes seen on the computed tomography in acute ischemic stroke of MCA territory. Aims: To evaluate the reliability of subjective evaluation of HMCAS on CT performed at multidetector CT (MDCT) and evaluated in the Picture Archiving Communication Systems, to define objective criteria for HMCAS and to find out if there are any predictors for the occurrence of HMCAS. Materials and Methods: CTs of 121 consecutive patients (mean age of 70 years) treated with thrombolytic therapy were retrospectively evaluated by two neuroradiologists both subjectively and objectively with respect to HMCAS. Results: HMCAS was subjectively found in 32% of study population. The interobserver and intraobserver agreement were substantial (K value of 0.69 and 0.80, respectively) and increased to almost perfect (Kvalue of 0.86) when the reader provided with clinical information. The HMCAS was found twice as often in male patients. Patients with HMCAS were three years younger than those whose baseline CT did not show HMCAS. A 100% sensitivity achieved when objective criteria were defined as combination of MCA attenuation >/= 46HU and MCA ratio > 1.2 (using oval ROIs) and MCA attenuation >/= 50 HU and MCA ratio of > 1.4 (using pixel sized ROIs). Conclusion: Performing CT examinations on MDCT and assessment of the images in PACS might have contributed to improvement of the reliability of evaluating HMCAS on CT by enabling an objective evaluation of this sign with measurements of attenuation value in the course of MCA using oval or pixel sized ROIs as well as estimation of MCA ratio . (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Neurology India
volume
57
issue
2
pages
143 - 150
publisher
Medknow Publications
external identifiers
  • wos:000266113200008
  • pmid:19439843
  • scopus:67249102389
ISSN
0028-3886
DOI
10.4103/0028-3886.51282
language
English
LU publication?
yes
id
5fef8cac-865c-4917-bf14-43c4bb7f0d57 (old id 1412304)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19439843?dopt=Abstract
date added to LUP
2009-06-03 13:08:26
date last changed
2017-01-01 07:51:00
@article{5fef8cac-865c-4917-bf14-43c4bb7f0d57,
  abstract     = {Background: The hyperdense middle cerebral artery sign (HMCAS) is one of the early changes seen on the computed tomography in acute ischemic stroke of MCA territory. Aims: To evaluate the reliability of subjective evaluation of HMCAS on CT performed at multidetector CT (MDCT) and evaluated in the Picture Archiving Communication Systems, to define objective criteria for HMCAS and to find out if there are any predictors for the occurrence of HMCAS. Materials and Methods: CTs of 121 consecutive patients (mean age of 70 years) treated with thrombolytic therapy were retrospectively evaluated by two neuroradiologists both subjectively and objectively with respect to HMCAS. Results: HMCAS was subjectively found in 32% of study population. The interobserver and intraobserver agreement were substantial (K value of 0.69 and 0.80, respectively) and increased to almost perfect (Kvalue of 0.86) when the reader provided with clinical information. The HMCAS was found twice as often in male patients. Patients with HMCAS were three years younger than those whose baseline CT did not show HMCAS. A 100% sensitivity achieved when objective criteria were defined as combination of MCA attenuation >/= 46HU and MCA ratio > 1.2 (using oval ROIs) and MCA attenuation >/= 50 HU and MCA ratio of > 1.4 (using pixel sized ROIs). Conclusion: Performing CT examinations on MDCT and assessment of the images in PACS might have contributed to improvement of the reliability of evaluating HMCAS on CT by enabling an objective evaluation of this sign with measurements of attenuation value in the course of MCA using oval or pixel sized ROIs as well as estimation of MCA ratio .},
  author       = {Abul-Kasim, Kasim and Selariu, Eufrozina and Brizzi, Marco and Petersson, Jesper},
  issn         = {0028-3886},
  language     = {eng},
  number       = {2},
  pages        = {143--150},
  publisher    = {Medknow Publications},
  series       = {Neurology India},
  title        = {Hyperdense middle cerebral artery sign in multidetector computed tomography: Definition, occurrence, and reliability analysis.},
  url          = {http://dx.doi.org/10.4103/0028-3886.51282},
  volume       = {57},
  year         = {2009},
}