Multidetector-CT Profile of Benign and Malignant Neck Masses among Patients of Guwahati, Assam

2021 ◽  
Vol 8 (30) ◽  
pp. 2743-2750
Author(s):  
Anil Kumar Geetha Virupakshappa ◽  
Ashok Kumar ◽  
Sushma Kenkare Lokanatha
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Predictive Value ◽  
Multidetector Ct ◽  
Surface Display ◽  
Final Diagnosis ◽  
Chi Square ◽  
Exact Test ◽  
Neck Masses ◽  
Neck Lesion

BACKGROUND Multidetector computed tomography (MDCT) is the imaging of choice and the most commonly used investigation in head and neck lesions, because of its fast and readily available nature. Our study focused on contrast enhanced multidetector CT profile of neck masses in determining their nature among different demographic profile. It provides volumetric helical data, optimal multiplanar and 3D reconstructions. METHODS This is a retrospective observational study carried out in the Department of Radiology, Gauhati Medical College and Hospital, Guwahati, among 60 cases of clinically diagnosed neck masses, from December 2011 to June 2013. All patients were selected from out-patient departments (OPD) and indoor wards of various departments (mostly from ENT department). Few cases were also taken from Dr. B. Baruah Cancer Institute. Patients from both sexes and all ages were included as part of the study. Chi square test/Fischer exact test have been used to find the significance of association of CT scan findings with the final diagnosis. Diagnostic statistics such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy have been used to find the correlation of CT scan with the final diagnosis. RESULTS Thin slice scanning with thinner reconstructions, maximum intensity production (MIP), shaded surface display (SSD), multiplanar reformation (MPR) and curved reformatted images are the advantages of MDCT. CT has 100 % accuracy in bony involvement detection and 96 % accuracy in neck lesion diagnosis. Therefore, CT can accurately localise and characterise the neck lesions. CONCLUSIONS The neck lesion location and its characteristics determination has significantly improved because of computed tomography. Bone erosions and expansion are accurately determined by a CT scan. CT scan can accurately delineate the disease that provides a definite pre-operative diagnosis, planning radiotherapy ports and post therapy follow up. KEYWORDS Bone Invasion, Lymph Nodes, Neck Space Extensions, Multidetector-CT

Abstract 2840: Aspect Score: DWI or CT Scan, Which One Is Better Marker For Stroke Morbidity And Outcome?

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Manoj Mittal ◽  
Raymond Seet ◽  
Zhang Yi ◽  
Alejandro Rabinstein
Keyword(s):  
Ischemic Stroke ◽  
Ct Scan ◽  
Acute Ischemic Stroke ◽  
Predictive Value ◽  
Univariate Analysis ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Exact Test ◽  
Good Outcome ◽  
The Difference

Background and Objective The Alberta Stroke Program Early CT Score (ASPECTS) is a validated grading system to assess ischemic changes on CT in acute ischemic stroke. Magnetic resonance imaging with diffusion weighted imaging (DWI) sequence is commonly used to identify the final ischemic changes. We examined the difference between the relationship of NIHSS at admission and ASPECT score calculated using CT scan versus MRI DWI sequence. Methods We conducted a retrospective analysis of prospectively collected data from 99 cases of acute ischemic stroke treated with IV rt-PA by time criteria, admitted to Mayo Clinic from March, 2002 through June, 2011. CT head at 24 hours and MRI DWI sequence were used to assign ASPECT score. We dichotomized ASPECTS (categorized as 0 to 7 versus 8 to 10) and favorable patient outcome at 3 month (modified Rankin score less than equal to 2 and more than 2). Univariate analysis including t-test, Chi-square, and Fisher Exact test was used when appropriate. Results Mean age was 70±14 years. Mean admission NIHSS score was 8±4. DWI ASPECTS (p<0.001) and CT ASPECTS (p=0.127) were inversely associated with admission NIHSS. Higher (8-10) CT ASPECTS (p=0.001) or DWI ASPECTS (p=0.002) were associated with good outcome (mRS ≤2) at 3 months. Sensitivity, specificity, positive predictive value and negative predictive value for good outcome identified by CT ASPECTS versus DWI ASPECTS were 81% vs 52%, 54% vs 54%, 83% vs 59% and 50% vs 47% respectively. Conclusion CT and MRI DWI are comparably useful to calculate the ASPECTS for estimation of functional outcome, but CT scan at 24 hours may be more sensitive for the prediction of good recovery.

Educational Review of Predictive Value and Findings of Computed Tomography Scan in Diagnosing Bowel and Mesenteric Injuries after Blunt Trauma: Correlation with Trauma Surgery Findings in 163 Patients

2017 ◽  
Vol 68 (3) ◽  
pp. 276-285 ◽  
Author(s):  
Francesco Cinquantini ◽  
Gregorio Tugnoli ◽  
Alice Piccinini ◽  
Carlo Coniglio ◽  
Sergio Mannone ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Predictive Value ◽  
Gold Standard ◽  
Clinical Management ◽  
Trauma Surgery ◽  
Trauma Patients ◽  
Increased Risk

Background and Aims Laparotomy can detect bowel and mesenteric injuries in 1.2%–5% of patients following blunt abdominal trauma. Delayed diagnosis in such cases is strongly related to increased risk of ongoing sepsis, with subsequent higher morbidity and mortality. Computed tomography (CT) scanning is the gold standard in the evaluation of blunt abdominal trauma, being accurate in the diagnosis of bowel and mesenteric injuries in case of hemodynamically stable trauma patients. Aims of the present study are to 1) review the correlation between CT signs and intraoperative findings in case of bowel and mesenteric injuries following blunt abdominal trauma, analysing the correlation between radiological features and intraoperative findings from our experience on 25 trauma patients with small bowel and mesenteric injuries (SBMI); 2) identify the diagnostic specificity of those signs found at CT with practical considerations on the following clinical management; and 3) distinguish the bowel and mesenteric injuries requiring immediate surgical intervention from those amenable to initial nonoperative management. Materials and Methods Between January 1, 2008, and May 31, 2010, 163 patients required laparotomy following blunt abdominal trauma. Among them, 25 patients presented bowel or mesenteric injuries. Data were analysed retrospectively, correlating operative surgical reports with the preoperative CT findings. Results We are presenting a pictorial review of significant and frequent findings of bowel and mesenteric lesions at CT scan, confirmed intraoperatively at laparotomy. Moreover, the predictive value of CT scan for SBMI is assessed. Conclusions Multidetector CT scan is the gold standard in the assessment of intra-abdominal blunt abdominal trauma for not only parenchymal organs injuries but also detecting SBMI; in the presence of specific signs it provides an accurate assessment of hollow viscus injuries, helping the trauma surgeons to choose the correct initial clinical management.

scholarly journals Efficacy of Ventilation Perfusion Lung Scanning and Computed Tomography Pulmonary Angiography for Chronic Thrombo-Embolic Pulmonary Hypertension

2020 ◽  
pp. 1-6
Author(s):  
Geoff Currie ◽  
Geoff Currie ◽  
Janelle Wheat ◽  
Michael Tong
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Diagnostic Imaging ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
High Probability ◽  
Lung Ventilation ◽  
Final Diagnosis ◽  
Pulmonary Angiography ◽  
Pulmonary Angiogram

Introduction: The diagnostic approach for patients with suspected Chronic Thrombo-Embolic Pulmonary Hypertension (CTEPH) is a combination of clinical and pre-test probability assessment, and diagnostic imaging of computed tomography pulmonary angiogram (CTPA) or lung ventilation and perfusion scintigraphy (V/Q). There is a paucity of literature, particularly for Southeast Asia (SEA) populations, regarding the efficacy of these imaging approaches. This study investigated the sensitivity and specificity of V/Q and CTPA in the diagnosis of CTEPH. Methods: A retrospective analysis was undertaken on 133 consecutive patients presenting for pulmonary hypertension (PH). The population included 42 males, 91 females, 683 V/Q images and 6288 CTPA images for patients in the age range 18 to 93 years (mean 66). All data was retrospectively analysed by two nuclear medicine physicians and classified as findings consistent with CTEPH or inconsistent with CTEPH. These classifications were independently and collectively correlated with a final diagnosis of CTEPH or no CTEPH. Results: The accuracy, sensitivity, and specificity of V/Q for detection of CTEPH was 83.5%, 57.5% and 97.7% respectively, with a positive predictive value (PPV) of 93.1% and a negative predictive value (NPV) of 80.8% when only high probability reports were considered CTEPH positive. The accuracy, sensitivity, and specificity of V/Q for detection of CTEPH was 96.2%, 97.9% and 95.4% respectively, with a PPV of 92.0% and a NPV of 98.8% when both high probability and intermediate probability reports were considered CTEPH positive. The accuracy, sensitivity and specificity of CTPA for detection of CTEPH were 70.7%, 19.2% and 98.8% respectively, with 90% PPV and 69.1% NPV. All 47 CTEPH studies were reported as having abnormal lung perfusion. Conclusion: This investigation has shown that V/Q is a more valuable diagnostic imaging tool in detecting CTEPH than CTPA. In suspected CTEPH, a high/intermediate V/Q report is consistent with a positive diagnosis. This is an important finding as CTEPH is a potentially treatable condition.

scholarly journals RADIOLOGICAL AND PATHOLOGICAL CORRELATION OF LUNG NODULES IN A BACKGROUND OF METASTATIC DISEASE

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Azra Akhtar ◽  
Noreen Akhtar ◽  
Sajid Mushtaq ◽  
Usman Hassan ◽  
Ali Raza Khan
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Lung Nodule ◽  
Age Groups ◽  
Lung Nodules ◽  
Diagnostic Challenge ◽  
Radiographic Appearance ◽  
Histopathological Findings

Background: Computed tomography (CT) imaging has improved the chances of detecting small indeterminate (<1 cm) lung nodules. The determination of the underlying malignant or benign nature of a lung nodule poses a great diagnostic challenge and depends on a number of factors, including the radiographic appearance of nodule, the presence of non-pulmonary metastases, characteristics of growth and histological criteria. Methods: The medical records of 89 patients admitted to our specialist cancer centre between 2008 and 2013 were reviewed. Patients of all age groups and tumour category were included in the study. Clinical data of these patients were collected and the following parameters were analysed: Radiographic diagnosis, location, size, laterality and number of nodules and histological impression. The radiological findings were then correlated with histopathological findings. The nodules were sub-classified into groups on the basis of size (A = 0–0.5 cm; B = 0.5–0.9 cm; C = 1.0–1.5 cm and D = >1.5 cm). Results: CT scan reports of 89 patients with lung nodules were reviewed. On radiology, 73/89 (82%) were reported to be malignant nodule. Histopathological review of the biopsies of these 89 nodules confirmed malignancy in 50/89 (56.2%) patients. CT scan was found to be highly sensitive (94%, 95% confidence interval [CI]: 83.43–98.68%) but with a very low specificity (33.3%, 95% CI: 19.10–50.22%). CT scan was found to have a higher negative predictive value (81.2%, 95% CI: 54.34–95.73%) and a lower positive predictive value 64.4% (95% CI: 52.31–75.25%) when correlated with histopathological findings. Pathology of these nodules included metastatic sarcoma (27/89; 30.3%) and carcinoma (18/89; 20.2%). The frequency of the biopsy-proven malignant nodules on the right side was 26/45 (57.8%) and on the left side was 24/44 (54.5%) (P = 0.832). Malignant nodules were more frequent in lower lobes (28/43, 65.1%) than in upper lobes (14/32, 43.8%). These two sites combined accounted for 84% of all malignant nodules. There was a significant correlation between nodule size and likelihood of underlying malignancy. The overall prevalence of malignancy in the larger nodules (C and D) was much higher (23/30 and 76.7%) compared to the smaller sized (A and B) nodules (27/58 and 46.8%), P < 0.05.Conclusion: CT scan is a useful tool in the initial clinical assessment of indeterminate lung nodules with high sensitivity (94%) and a high negative predictive value (81.2%).Key words: Computed tomography, fibrosis, indeterminate lung nodule, infection, lung nodule, malignancy, metastases

Quantitative Computed Tomography Image Analysis to Predict Pancreatic Neuroendocrine Tumor Grade

2021 ◽  
pp. 679-694
Author(s):  
Alessandra Pulvirenti ◽  
Rikiya Yamashita ◽  
Jayasree Chakraborty ◽  
Natally Horvat ◽  
Kenneth Seier ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Analysis ◽  
Ct Scan ◽  
Predictive Value ◽  
Quantitative Computed Tomography ◽  
Tumor Grade ◽  
Quantitative Image Analysis ◽  
Arterial Phase ◽  
Imaging Method ◽  
Quantitative Image

PURPOSE The therapeutic management of pancreatic neuroendocrine tumors (PanNETs) is based on pathological tumor grade assessment. A noninvasive imaging method to grade tumors would facilitate treatment selection. This study evaluated the ability of quantitative image analysis derived from computed tomography (CT) images to predict PanNET grade. METHODS Institutional database was queried for resected PanNET (2000-2017) with a preoperative arterial phase CT scan. Radiomic features were extracted from the primary tumor on the CT scan using quantitative image analysis, and qualitative radiographic descriptors were assessed by two radiologists. Significant features were identified by univariable analysis and used to build multivariable models to predict PanNET grade. RESULTS Overall, 150 patients were included. The performance of models based on qualitative radiographic descriptors varied between the two radiologists (reader 1: sensitivity, 33%; specificity, 66%; negative predictive value [NPV], 63%; and positive predictive value [PPV], 37%; reader 2: sensitivity, 45%; specificity, 70%; NPV, 72%; and PPV, 47%). The model based on radiomics had a better performance predicting the tumor grade with a sensitivity of 54%, a specificity of 80%, an NPV of 81%, and a PPV of 54%. The inclusion of radiomics in the radiographic descriptor models improved both the radiologists' performance. CONCLUSION CT quantitative image analysis of PanNETs helps predict tumor grade from routinely acquired scans and should be investigated in future prospective studies.

scholarly journals Diagnostic accuracy of renal calculi on ultrasonography taking computed tomography as gold standard

2021 ◽  
Vol 8 (7) ◽  
pp. 3269
Author(s):  
Hina Pathan ◽  
M. Kashif Shazlee ◽  
Junaid Iqbal ◽  
Ashraf A. Ali ◽  
Kamran Hameed ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Surgical Approach ◽  
Gold Standard ◽  
Ultrasound Examination ◽  
Renal Calculi ◽  
Final Diagnosis ◽  
Clinical Suspicion ◽  
Number Of Patients

Background: Ultrasonography is a useful modality to diagnose stones and to confirm the occurrence of complications of other renal pathology, so it is important to understand these characteristic findings and other diseases that mimic them. In addition, other imaging modalities such as computed tomography (CT) can be recommended if the clinical or radiological diagnosis is ambiguous.Methods: A group of 325 patients with clinical suspicion of renal calculi were included in this study. Out of these 325 patients 179 (55.0%) were male and 146 (44.9%) were female. All these patients underwent ultrasonography (USG) examination. Final diagnosis was based on CT findings which was done subsequently.Results: The total number of patients comprising the study were 325 who underwent ultrasound examination. After USG and CT scan was done to confirm the diagnosis. Out of 325 patients, 201 patients were confirmed having renal calculi on USG analysis and remaining 103 patients were true negative.Conclusions: The study proves that USG is highly accurate in diagnosing and characterizing renal calculi. USG also guides in defining exact location as well as aids in deciding the medical or surgical approach to be used.

scholarly journals Comparison of positive predictive value of computed tomography versus diagnostic peritoneal lavage for diagnosis of solid organ damage in patients with blunt abdominal trauma

2019 ◽  
Vol 26 (06) ◽  
Author(s):  
Abdul Ghaffar ◽  
Saeed Mahmood ◽  
Muhammad Kareemullah ◽  
Saqib Uddin Khan ◽  
Ambreen Akram ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positive Predictive Value ◽  
Ct Scan ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Predictive Value ◽  
Peritoneal Lavage ◽  
Organ Damage ◽  
Solid Organ ◽  
Diagnostic Peritoneal Lavage

Background: Abdominal trauma can be mysterious to some practitioners. If patients are evaluated for being stable or unstable, then abdominal trauma can be easily managed. Using a combination of physical examination, eFAST Scan, DPL and CT scans, patients can be quickly and efficiently evaluated. Objectives: To determine the positive predictive value (PPV) of computed tomography and diagnostic peritoneal lavage for diagnosis of solid organ damage in patients with blunt abdominal trauma (BAT) taking surgical findings as gold standard. Study Design: Cross sectional study. Setting: Department of Surgery at Lahore General Hospital, Lahore. Period: Six months i.e. from 21.5.2016 to 20.11.2016. Materials and Methods: Data Collection: CT scan was performed with oral and intravenous contrast. DPL was done with sample assessment. Only those cases were included with positive findings in CT Scan or DPL. These patients underwent laparotomy under general anesthesia by a one standard surgical team. Results of surgical findings were compared between groups with CT scan and DPL. All the information was collected on predesigned proforma. Results: The mean age of the patients was 44.48±14.83 years. There were 66 (55%) males and 54 (45%) females in our study. In this study PPV for CT-scan group was 90.1% while PPV for group with DPL was 51.3%. Conclusion: PPV for CT Scan group was higher than that of DPL group for diagnosing solid organ damage in patients with BAT. Hence, evidence shows that CT Scan should be used as an initial investigation of choice in haemo-dynamically stable patients with BAT.

scholarly journals Diagnostic Accuracy of MDCT (Multidetector Computed Tomography) for Staging of Renal Cell Carcinoma

2021 ◽  
Vol 15 (7) ◽  
pp. 1471-1474
Author(s):  
Sadaf Gill ◽  
Sarah Nisar ◽  
Lubna Sarfraz ◽  
Khaula Sidra ◽  
Arshad Faheem ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Ct Scan ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Multidetector Ct ◽  
False Negative ◽  
Radiology Department ◽  
True Negative ◽  
Cross Sectional

Background: The advancement in technology has introduced multi-detector CT scanners and achievement of better spatial resolution with faster acquisition has become a possibility. The three-dimensional reformatted images along with multiplanar reconstructions upgrade the staging capabilities for RCC. Aim: To check accuracy of MDCT (Multi-detector Computed tomography) in staging renal cell carcinoma with histopathology taken as the gold standard. Study design: The study is a descriptive cross sectional study. Settings: Radiology Department, Bahawal Victoria Hospital, Bahawalpur Study duration: 16"' January 2019 to 15"' July 2019. Methods 157 patients (including both genders) were included with age range of 25-60 years, showing features of renal cell carcinoma on ultrasonography. Those Patients with renal mass other than renal cell carcinoma, solitary functioning kidney and pregnant females were eliminated from the study. All the selected patients had Multi-detector CT scan abdomen performed. Results: Mean age was 44.66+9.3 I years. Out of these 157 patients, there were 90(57.32) male patients and 67 (42.68°/c) females with ratio of I.3: I. All the patients had CT scan of abdomen and pelvis. The results showed that 8I of the patients were True Positive and only 08 were False Positive. Out of 68 CT negative patients, 07 (False Negative) showed renal cell carcinoma on histopathology while 6 I True Negative patients had no evidence of RCC on histopathology (p=0.0001). Conclusion: Multi-detector CT scan is a very sensitive yet accurate non - invasive method for staging renal cell ca. Keywords: Renal cell carcinoma, multidetector CT scan, imaging, sensitivity

Postprocessing in Maxillofacial Multidetector Computed Tomography

2015 ◽  
Vol 66 (3) ◽  
pp. 212-222 ◽  
Author(s):  
Silvio Mazziotti ◽  
Alfredo Blandino ◽  
Michele Gaeta ◽  
Antonio Bottari ◽  
Carmelo Sofia ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Multidetector Ct ◽  
Surface Display ◽  
Maximum Intensity Projection ◽  
Longitudinal Axis ◽  
Theoretical Assumption ◽  
3 Dimensional ◽  
Volumetric Rendering ◽  
Rendering Techniques

Multidetector computed tomography (CT) and volumetric rendering techniques have always been a useful support for the anatomical and pathological study of the maxillofacial district. Nowadays accessibility to multidetector CT scanners allows the achievement of images with an extremely thin collimation and with high spatial resolution, not only along the axial plane but also along the patient's longitudinal axis. This feature is the main theoretical assumption for multiplanar imaging and for an optimal 3-dimensional postprocessing. Multiplanar reconstruction (MPR) techniques permit images along any plane in the space to be obtained, including curved planes; this feature allows the representation in a single bidimensional image of different anatomical structures that develop on multiple planes. For this reason MPR techniques represent an unavoidable step for the study of traumatic pathology as well as of malformative, neoplastic, and inflammatory pathologies. Among 3-dimensional techniques, Maximum Intensity Projection and Shaded Surface Display are routinely used in clinical practice. In addition, volumetric rendering techniques allow a better efficacy in representing the different tissues of maxillofacial district. Each of these techniques give the radiologist an undoubted support for the diagnosis and the characterization of traumatic and malformative conditions, have a critical utility in the neoplastic evaluation of primary or secondary bone involvement, and are also used in the planning of the most modern radiosurgical treatments. The aim of this article is to define the main technical aspects of imaging postprocessing in maxillofacial CT and to summarize when each technique is indicated, according to the different pathologies of this complex anatomical district.

scholarly journals Comparison of Clinical Diagnosis of Stroke with Computed Tomographic Scan of the Brain

2013 ◽  
Vol 28 (2) ◽  
pp. 96-101
Author(s):  
Sirajee Shafiqul Islam ◽  
Aminur Rahman ◽  
Md Manzur Alahi ◽  
Md Ahmed Ali ◽  
Md Kafiluddin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Positive Predictive Value ◽  
Intracerebral Hemorrhage ◽  
Ct Scan ◽  
Clinical Diagnosis ◽  
Predictive Value ◽  
Hemorrhagic Stroke ◽  
Sensitivity Specificity ◽  
The Brain

Background and purpose: Stroke is a leading cause of mortality and morbidity in both developed as well as developing countries. The clinical presentation of stroke depending on the site and extent of lesions. For the management purpose it is important to know whether we are dealing with a bleed or an infarct. Methodology: Computed Tomography (CT scan) is available most of the tertiary level hospitals in Bangladesh. This study was carried out to compare clinical diagnosis of stroke with Computed tomography (CT) scan findings in ascertaining the type of stroke (hemorrhagic or ischemic). Materials and methods: This cross-sectional comparative study was conducted in the Department of Neurology, Rajshahi Medical College Hospital during the period of January 2010 to December 2010. Total 200 stroke patients were selected by purposive sampling technique on the basis of inclusion and exclusion criteria as the study sample. . CT brain scan was done for all the patients. The clinical diagnosis was compared with the results of CT scan and performance test was done. Results: Clinically 67 patients were diagnosed as hemorrhagic stroke and 133 patients were diagnosed as ischemic stroke. Out of these 67 hemorrhagic patients CT scan revealed that 56 patients had intracerebral hemorrhage, 5 had infarct, 4 had subarachnoid hemorrhage and 2 had space occupying lesions in the brain. Out of these 133 ischemic patients CT scan revealed that 119 patients had infarction, 6 had intracerebral hemorrhage and 8 had space occupying lesions in the brain. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical diagnosis of hemorrhagic stroke were 90.32%, 92.03%, 83.58%, 92.02% and 91.5% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical diagnosis of ischemic stroke were 95.96%, 81.58%, 89.47%, 92.53% and 90.5% respectively. Conclusion: The diagnosis of stroke in clinically with high accuracy, but perform a CT scan will help to confirm and differentiate to type stroke. Thus CT scan should be done in all cases stroke to specify the diagnosis. DOI: http://dx.doi.org/10.3329/bjn.v28i2.17179 Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 96-101

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