Potential Role of 2-Phase Cardiac CT in Patients With Embolic Stroke of Undetermined Source

Am J Med. 2020 Jun;133(6):e290-e293. doi: 10.1016/j.amjmed.2019.11.019. Epub 2019 Dec 20.

Abstract

Background: Recent trials failed to demonstrate that anticoagulation was superior to antiplatelet agents in preventing recurrent stroke after embolic stroke of undetermined source (ESUS), which may be as a result of the heterogeneity of etiology. We thus investigated whether the use of 2-phase cardiac computed tomography (CT) could help to evaluate the etiology in patients with ESUS.

Methods: We performed 2-phase cardiac CT in patients with ESUS and evaluated whether there was positive cardiac findings.

Results: A total of 74 patients with ESUS were enrolled. Positive cardiac findings were found in 21 (28.4%) patients, including intracardiac thrombus (n = 5), complex aortic plaque (n = 9), and patent foramen ovale (PFO) (n = 8). Both complex aortic plaque and patent foramen ovale were identified in 1 patient.

Conclusions: Two-phase cardiac CT is a useful tool for stroke etiology evaluation, providing diagnostic information in a quarter of patients with ESUS.

Keywords: Cardiac imaging; Embolism; Etiology; Stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Diseases / complications
  • Aortic Diseases / diagnostic imaging*
  • Contrast Media
  • Female
  • Foramen Ovale, Patent / complications
  • Foramen Ovale, Patent / diagnostic imaging*
  • Heart Diseases / complications
  • Heart Diseases / diagnostic imaging*
  • Humans
  • Intracranial Embolism / etiology*
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic / complications
  • Plaque, Atherosclerotic / diagnostic imaging*
  • Thrombosis / complications
  • Thrombosis / diagnostic imaging*
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media