RT Journal Article
SR Electronic
T1 Hyperdense middle cerebral artery sign on CT: efficacy in detecting middle cerebral artery thrombosis.
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 473
OP 477
VO 11
IS 3
A1 Tomsick, T A
A1 Brott, T G
A1 Chambers, A A
A1 Fox, A J
A1 Gaskill, M F
A1 Lukin, R R
A1 Pleatman, C W
A1 Wiot, J G
A1 Bourekas, E
YR 1990
UL http://www.ajnr.org/content/11/3/473.abstract
AB The hyperdense middle cerebral artery sign is a CT predictor of the development of a large cerebral infarct. The limits of detectability were tested in a blinded, then unblinded analysis of CT scans from 25 acute stroke patients. In the initial blinded analysis, sign detection exhibited the following mean values: sensitivity, 78.5%; specificity, 93.4%; positive predictive value, 66%; negative predictive value, 96.4%; accuracy, 91.3%. Kappa statistics analysis indicated poor interobserver agreement (k = .38). Results of unblinded analysis were as follows: sensitivity, 69%; specificity, 94.4%; positive predictive value, 82.8%; negative predictive value, 88.7%; accuracy, 87.3%. There was fair unblinded interobserver agreement (k = .53). Unblinded analysis had a lower false-positive frequency and did not increase the number of true-positive determinations. We conclude that detection of the hyperdense middle cerebral artery sign on CT scans by multiple observers is a sensitive, accurate, and predictive indicator of middle cerebral artery thromboembolism.