Potential Role of 2-Phase Cardiac CT in Patients With Embolic Stroke of Undetermined Source.

BACKGROUND

Recent trials failed to demonstrate that anticoagulation was superior to antiplatelet agents in preventing recurrent stroke after embolic stroke of undetermined source (ESUS), which may be as a result of the heterogeneity of etiology. We thus investigated whether the use of 2-phase cardiac computed tomography (CT) could help to evaluate the etiology in patients with ESUS.

METHODS

We performed 2-phase cardiac CT in patients with ESUS and evaluated whether there was positive cardiac findings.

RESULTS

A total of 74 patients with ESUS were enrolled. Positive cardiac findings were found in 21 (28.4%) patients, including intracardiac thrombus (n = 5), complex aortic plaque (n = 9), and patent foramen ovale (PFO) (n = 8). Both complex aortic plaque and patent foramen ovale were identified in 1 patient.

CONCLUSIONS

Two-phase cardiac CT is a useful tool for stroke etiology evaluation, providing diagnostic information in a quarter of patients with ESUS.