Akash M Patel MD, Presenter: Nothing to Disclose

Subhash Kumar MBBS, Abstract Co-Author: Nothing to Disclose

Digish Vaghela MD, Abstract Co-Author: Nothing to Disclose

Dharti Patel DMRD, Abstract Co-Author: Nothing to Disclose

Darshan Patel MBBS, Abstract Co-Author: Nothing to Disclose

Tejal Patel, Abstract Co-Author: Nothing to Disclose

Rajendra Naginbhai Solanki MD, Abstract Co-Author: Nothing to Disclose

Hasmukh Jagdishbhai Prajapati MBBS, Abstract Co-Author: Nothing to Disclose

Bhavesh Talsaniya MBBS, Abstract Co-Author: Nothing to Disclose

Urvil Shah, Abstract Co-Author: Nothing to Disclose

Pankaj Amin MD, Abstract Co-Author: Nothing to Disclose

Nilesh Gajjar MD, Abstract Co-Author: Nothing to Disclose

Hitesh Rajpura MD, Abstract Co-Author: Nothing to Disclose

Jayesh Patel, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To find the necessity of contrast-enhanced CT scan of the brain in comparison to plain CT alone in evaluation of brain pathologies at all age groups.

1315 plain and contrast CT scans of brain in patients of all age groups performed over last fourteen months of patients of all groups were reviewed by two radiologists using double blind randomized control. Post-operative, post-traumatic scans and congenital malformations were not included.

632 positive cases were in adult age group (> 12 years) while 310 positive cases were < 12 years. In adults commonest pathologies were ischemic stroke (291), hemorrhagic stroke (92), infection (129) and neoplasms (77). In children, the commonest pathologies were infection (176), ischemic sequelae (39) and miscellaneous conditions (95). CECT added significant information in 9.81%, added minor information in 41.97%, added no extra information in a positive NECT scan in 16.88% while no abnormality was detected on either scans in 31.33%). The use of contrast material changes the original diagnosis in only 3.85%. CECT gives significant information in (1) clinico-pathologically suspected disease with normal NECT, (2) indeterminate findings on NECT, (3) suspected malignancy, (4) indeterminate lesions with peripheral ring and (5) vascular lesions.

In most conditions CECT does not add significant information. CECT is useful in clinico-pathologically suspected disease with normal NECT, indeterminate findings on NECT, suspected malignancy, indeterminate rim enhancing lesions and in vascular malformations.

Considering the cost,radiation, contrast induced complications, NECT brain alone will fullfill clinical requirements in most of the cases, while CECT should be done according to NECT findings.

Patel, A, Kumar, S, Vaghela, D, Patel, D, Patel, D, Patel, T, Solanki, R, Prajapati, H, Talsaniya, B, Shah, U, Amin, P, Gajjar, N, Rajpura, H, Patel, J, et al, , A Large Study Raising Questions Over the Necessity of Contrast-enhanced CT Brain as Opposed to Plain Scan.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4439913.html