| 응급실에 내원한 어지럼증 환자 평가에 있어 뇌 전산화단층촬영 혈관조영술의 유용성 |
박주민1
, 이성은1,2
, 이성준2
, 최상천1
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1아주대학교 의과대학 응급의학과교실
2아주대학교 의과대학 신경과학교실 |
| Usefulness of computed tomography angiography findings for evaluation of patients with dizziness in the emergency department |
| Ju Min Park1
, Sung Eun Lee1,2
, Seong-Joon Lee2
, Sangchun Choi1
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1Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
2Department of Neurology, Ajou University School of Medicine, Suwon, Korea |
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Received: September 2, 2021; Revised: October 21, 2021 Accepted: November 22, 2021. Published online: August 31, 2022. |
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| ABSTRACT |
Objective:
Dizziness is a common symptom in the emergency department. Identifying central causes, such as acute ischemic stroke (AIS), is essential in patients with dizziness. This study examined the usefulness of computed tomographic angiography (CTA) for the safe disposition of patients with dizziness when brain magnetic resonance imaging (MRI) is difficult to perform.
Method:
This study was a retrospective observational study. Patients who underwent CTA and MRI to determine the cause of dizziness were included in this study between January 2019 and December 2019. Clinical and radiological characteristics, including the CTA findings, were compared in groups with and without AIS in MRI. Univariate and multivariate logistic regression analyses were performed. The area under the receiver operating characteristic curve (AUROC) was assessed.
Results:
Three hundred and fifty patients were included in the study. Of these patients, 63 patients had AIS in MRI. The group with AIS was more frequently male (65.1% vs. 44.3%, P=0.003), had dysarthria (9.5% vs. 2.4%, P=0.016), and relevant vertebral or basilar artery stenosis or occlusion on CTA (66.7% vs. 3.5%, P<0.001). In logistic regression, relevant vertebral or basilar artery stenosis or occlusion was significantly associated with AIS in MRI (odds ratio, 47.941; 95% confidence interval, 20.857-110.195; P<0.001). In the receiver operating characteristic curve, the relevant vertebral or basilar artery stenosis or occlusion on CTA was a feasible predictive value for diagnosing AIS (AUROC, 0.816).
Conclusion:
This study showed that the CTA findings were feasible for predicting the safety disposition of patients with dizziness when MRI is difficult to perform. |
| Key words:
Dizziness; Acute ischemic stroke; Computed tomographic angiography; Magnetic resonance imaging; Emergency department; Safety disposition |
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