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Master Thesis

Place du scanner cardiaque dans le bilan étiologique des accidents vasculaires cérébraux ischémiques : revue systématique de la littérature

Abstract : Objective: Assess the interest of cardiac CT-scan for the detection of cardio-embolic causes during the initial ischemic stroke assessment. Materials and methods: We conducted a systematic literature review of articles published before June 2021 using PubMed, Cochrane and Google Scholar search engines. Studies were included if they included the following data, (1) cardiac CT-scan with or without cardiac ultrasound, (2) patients with a recent stroke or TIA, (3) the number and type of cardio-embolic sources recovered. Results: Twenty-three studies met the inclusion criteria, with a total of 3016 scanned patients. Studies specifically comparing scanner and transesophageal echocardiography (TEE) showed thrombi in 6.5% of the patients with the scanner and 5% with TEE. Severe aortic atheromatous plaques were identified in 27% of patients with CT-scan versus 15% with ultrasound (transthoracic echography and/or TEE). For inter-atrial septal abnormalities, 15.3% of patients had an identifiable patent foramen ovale (PFO) using CT-scan versus 24% using ultrasound (transthoracic echography and/or TEE). Conclusion: Our study suggests that cardiac CT-scan is more efficient than cardiac ultrasound for detecting intra-cardiac thrombi and severe aortic atherosclerosis plaques. However, cardiac ultrasound seems to be better for PFO detection. Cardiac CT-scan et cardiac ultrasound appear to be complementary imaging modalities in the etiological assessment of ischemic strokes. More studies need to be conducted to compare each types of imaging (MRI, US, CT…) in the initial ischemic stroke assessment.
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Submitted on : Thursday, February 17, 2022 - 4:04:42 PM
Last modification on : Saturday, April 2, 2022 - 3:38:36 AM
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Filwa Benkhai. Place du scanner cardiaque dans le bilan étiologique des accidents vasculaires cérébraux ischémiques : revue systématique de la littérature. Médecine humaine et pathologie. 2021. ⟨dumas-03578878⟩



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