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| Comprehensive analysis of the high density of middle cerebral artery sign in hyperacute cerebral infarction |
| LIN Hui-hua1, WANG Rui-fang2, NING Qing-ling1, XU Zhi-hua1, YANG Ben-qiang3,#br# ZHANG Meng-zhi1, CAI Xiao-nan3, HOU Jie1, DUAN Yang3 |
1. Jinzhou Medical University, General Hospital of Shenyang Military Region Command Training Base for Graduate,
Shenyang 110016, China; 2. Department of Radiology, Liaoning General Hospital of Armed Police, Shenyang 110034, China;
3. Department of Radiology, General Hospital of Shenyang Military Region Command of PLA, Shenyang 110016, China |
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Abstract Objective: To explore objective criteria which are suitable for clinical application by comprehensive analysis of unilateral hyperdense middle cerebral artery sign(HMCAS) on non-enhanced computed tomography(NECT). Methods: One hundred sixteen patients with hyperacute cerebral infarction were retrospectively evaluated. The presence of HMCAS was evaluated between inter- and intra-observers. K value was calculated. The cut off value of MCA attenuation and MCA ratio(the affected side/the healthy side) in the HMCAS(+) and HMCAS(-) was measured through the ROC curve in all patients with hyperacute cerebral infarction. The sensitivity and specificity was analyzed. Results: The interobserver and intraobserver agreement were substantial(K value of 0.82 and 0.86, respectively) and increased to almost perfect(K value of 0.95) when the reader was provided with clinical information. MCA attenuation≥40 HU and MCA ratio≥1.2 was the best threshold for HMCAS recognition. When both MCA attenuation≥40 HU and MCA ratio≥1.2 were satisfied, sensitivity(91.23%) and specificity(100%) were the highest relative to other standards. Conclusion: It is effective and feasible to evaluate the unilateral HMCAS on NECT images by combining with clinical history. MCA attenuation≥40 HU and MCA ratio≥1.2 was the best threshold for HMCAS recognition, which is suitable for application in daily clinical practice.
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Received: 12 October 2017
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2018, Vol. 29 
