Radiology, Vol 131, 393-398, Copyright © 1979 by Radiological Society of North America
Sensitivity of computed tomography and serial scintigraphy in cerebrovascular disease
U Buell, E Kazner, M Rath, H Steinhoff, E Kleinhans and W Lanksch
Computed tomography and serial scintigraphy with 99mTc-pertechnetate
(radionuclide angiography and early and late static imaging) were compared
in 214 patients with cerebrovascular disease. CT correctly identified 151
(95.0%) of 159 patients with completed ischemic stroke but was positive in
only 11 (25%) of 44 patients with asymptomatic stenosis, transient ischemic
attacks (TIA), or prolonged reversible ischemic neurological deficit
(PRIND). Scintigraphy was positive in 93.1% of patients with completed
stroke. CT detected 175 territories of vascular supply involved,
scintigraphy 164. In patients with asymptomatic stenosis, TIA, or PRIND,
scintigraphy was correct in 77.3% of cases. The combined evaluation offered
a sensitivity of 97.5% in patients with completed stroke and 86.4% in those
with asymptomatic stenosis, TIA, or PRIND. The rate of true-positive
scintigraphic findings in patients with completed stroke did not change as
the interval between ictus and study increased. In patients with
intracerebral hematoma, CT was far more specific than scintigraphy. If
cerebrovascular disease is suspected, radionuclide angiography should be
performed first.
