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CT of the head for acute stroke: Diagnostic performance of a tablet computer prior to intravenous thrombolysis
Author(s) -
McLaughlin Patrick D,
Moloney Fiachra,
O'Neill Siobhan B,
James Karl,
Crush Lee,
Flanagan Oisin,
Maher Michael M,
Wyse Gerald,
Fanning Noel
Publication year - 2017
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12585
Subject(s) - medicine , thrombolysis , neuroradiologist , radiology , subdural haematoma , stroke (engine) , iodinated contrast , acute stroke , emergency department , magnetic resonance imaging , computed tomography , myocardial infarction , engineering , mechanical engineering , psychiatry
Abstract Introduction The authors propose that tablet computers could benefit patients with acute stroke in the remote care setting, where time to and accuracy of CT interpretation greatly influences patient outcome. Methods One hundred and fifty consecutive patients who presented to the Emergency Department of a tertiary referral neurosciences centre within a time window suitable for intravenous thrombolytic therapy were included. Images were wirelessly transmitted to a tablet computer ( iP ad 3rd Generation, model = A1430, Apple, Cupertino, CA ) and were reviewed by radiologists with three levels of experience for signs of intracranial haemorrhage, large vessel occlusion and parenchymal infarction. Reference standard interpretation was performed by two neuroradiologists using a diagnostic monochrome display. Results Consensus neuroradiologist review on the tablet display found and correctly classified all of the 23 cases of intracranial haemorrhage including 21 cases of parenchymal haematoma, two cases of petechial haemorrhage and one patient with an acute subdural haematoma. Less experienced readers missed cases of petechial and subdural haematomas. There was excellent agreement between the tablet and diagnostic monochrome display in cases with no infarct or extensive parenchymal infarction. Conclusions Tablet computers can be used to facilitate rapid preliminary CT interpretation in patients with acute stroke in the remote setting.