Extended CTA exams more than triple stroke detection
Expanding CT angiography imaging to include the heart and aorta when an individual is suspected of having had a stroke could significantly enhance the detection of hidden blood clots.
That’s according to new research published this week in The Lancet Neurology, where researchers suggested that extending the area imaged during head-to-neck CT angiography by at least 6 cm below the carina can increase the detection of cardioaortic thrombi by as much as 600% in patients with ischemic stroke or transient ischemic attack. Experts involved in the study indicated their findings could improve providers’ ability to diagnose and manage strokes, as treatment depends on the location of the blood clot blocking blood flow to the brain.
“Identifying where the clot came from is essential because it determines the safest and most effective treatment,” Luciano Sposato, MD, head of the Southwestern Ontario Regional Stroke Center at London Health Sciences Center (LHSC), and a professor of neurology at Schulich Medicine & Dentistry, and colleagues noted. “If the clot originated in the heart, we typically use blood thinners to prevent future strokes.”
The study included 463 patients who had been assessed for ischemic stroke or transient ischemic attack at LHSC’s University Hospital between July of 2023 and May of 2024. Patients were divided into two groups—one that underwent standard CTA imaging of the head and neck, and one that had their field of view extended below the carina.
Cardioaortic thrombi were located in 20 patients from the extended group and in just 4 patients who received standard imaging. There were no statistical differences in the median time from code stroke activation to CT angiography completion between the groups, and scan times increased by an average of just one minute using the extended protocol.
“If we did not extend the CT scan, some of these blood clots may not have been found and these strokes would have been classified as having an undetermined cause,” the authors noted, adding that this could have led to patients receiving less effective treatments.
The authors suggested that future research into the extended method should assess whether the extended imaging method improves outcomes by identifying cardioaortic blood clots earlier, prompting more timely treatment.
The study is available here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.