Computed tomography angiography findings in adult stroke patients presenting at radiology department, Muhimbili National Hospital

Abstract

ABSTRACT BACKGROUND Stroke continues to be one of the most debilitating disease that either leads to disability or morbidity among different ethnicities in the world. In 2008 WHO had estimated deaths by stroke to be 5.7million worldwide which has now risen to 6.24million deaths and projected to be at 7.8million deaths by 2030. The current advancement of technology makes it possible to recognize stroke at an early stage and hence treatment can be planned accordingly. One of such tools is the use of CTA which can be used to outline the cause of stroke and can further be used to pinpoint the location of the problem and hence making it easier for the clinicians to carry out the required interventional procedures. Therefore, it is imperative to apply the use of CTA in sorting outpatients with stroke especially since CT scanners are readily available even in most of the developing countries. BROAD OBJECTIVE To determine Computed Tomography angiography findings in adult patients with stroke presenting at the Radiology department, Muhimbili National hospital from September 2018 to February 2019. METHODOLOGY The study was conducted at the Radiology department at MNH by using a cross-sectional analysis method and a convenience sampling technique. This study included 86 patients who were diagnosed with stroke and were referred for CTA at the department. Images were interpreted by the primary Investigator and proof-read by the Radiologist. When a difference arose on the interpretation, a senior Radiologist was consulted and results recorded when the consensus was reached. A well-structured questionnaire was used to collect data which were later on analyzed using SPSS version 20. Data was presented in simple frequency tables and charts. Statistical Association of descriptive data was done using chi-square. A p value of <0.05 was considered significant. All images were obtained using the ALARA technique. vi RESULTS This study included 86 stroke patients, among which males were 45 and 41 were females. The age range was between 18-95. Ischemic stroke was found to have a higher prevalence (60.5%) compared to hemorrhagic stroke (39.5%). Of the angiographic patterns examined, stenosis was found to be the commonest abnormal pattern represented by 36%, of which most occurred intracranially (72.2%) as compared to extracranial (27.8%). MCA was the commonest affected vascular territory (29.4%). Among the four modifiable risk factors, hypertension and diabetes mellitus were the only two that had a strong association with stenosis. CONCLUSION Stenosis was the commonest abnormal angiographic pattern seen in patients with stroke with a higher prevalence in intracranial segments (72.2%). Among the vascular territories analyzed, MCA had a high prevalence of all. Anterior circulation showed high preponderance as compared to posterior circulation. Hypertension and diabetes mellitus were the two risk factors that showed a significant association with the stenosis (p-value <0.05).