Extending Stroke CT Angiography to the Full Chest Allows for the Detection of Additional Pulmonary Opacifications in Acute Stroke Patients

Background and Purpose: During epidemics with an increased prevalence of pulmonary infections, extending stroke CTA examinations of acute stroke work up to the whole chest may allow for the identification of pulmonary findings that would have been missed on standard CTA examinations. Materials and Methods: Our analysis comprised 216 patients with suspicion of stroke who received extended full-chest cerebrovascular CTA examinations from January 27th 2020 - date of the first confirmed Covid-19 case in Germany - until April 30th 2020. Results: Consolidations and ground-glass opacifications were found in 73 of all 216 patients (34%). Opacifications were found in the upper chest in 51/216 patients (23%). There were lower-chest opacifications in 22 of 165 patients (13%) with unsuspicious upper-chest scans. In these 22 patients, there were consolidations in 10 cases (45%), ground-glass opacifications in 10 cases (45%), and both in 2 cases (10%). Conclusion: Our study showed that extending the scan volume of an emergency stroke CTA to the whole chest reveals a considerable number of opacifications that would have been missed on a standard CTA. Even though these findings were rarely indicative of COVID-19, a large number of opacifications warranted further investigation.