Potential role of two-phase cardiac CT in patients with embolic stroke of undetermined source.

-BACKGROUND: Recent trials failed to demonstrate that anticoagulation was superior to antiplatelet agents in preventing recurrent stroke after embolic stroke of undetermined source (ESUS), which may be as a result of the heterogeneity of etiology. We thus investigated whether the use of 2-phase cardiac computed tomography (CT) could help to evaluate the etiology in patients with ESUS. METHODS: We performed 2-phase cardiac CT in patients with ESUS and evaluated whether there was pos-itive cardiac findings. RESULTS: A total of 74 patients with ESUS were enrolled. Positive cardiac findings were found in 21 (28.4%) patients, including intracardiac thrombus (n = 5), complex aortic plaque (n = 9), and patent foramen ovale (PFO) (n = 8). Both complex aortic plaque and patent foramen ovale were identified in 1 patient. CONCLUSIONS: Two-phase cardiac CT is a useful tool for stroke etiology evaluation, providing diagnostic information in a quarter of patients with ESUS. (C) 2019 Elsevier Inc. All rights reserved.