Comparison of 64-Slice Vs 128-Slice CT in Stroke Imaging: A Comprehensive Review

Authors

Lalruatfela

Department of Medical Radiology and Imaging Technology Regional Institute of Paramedical and Nursing Sciences Aizawl Mizoram (India)

R Lalnunsangi

Department of Medical Radiology and Imaging Technology Regional Institute of Paramedical and Nursing Sciences Aizawl Mizoram (India)

Article Information

DOI: 10.51584/IJRIAS.2025.101100091

Subject Category: Religious Studies

Volume/Issue: 10/11 | Page No: 963-970

Publication Timeline

Submitted: 2025-12-04

Accepted: 2025-12-10

Published: 2025-12-19

Abstract

Rapid and accurate neuroimaging is essential for acute stroke management, guiding decisions for thrombolysis and mechanical thrombectomy. Multidetector computed tomography (MDCT) systems—particularly 64-slice and 128-slice scanners—are widely used for non-contrast CT (NCCT), CT angiography (CTA), and CT perfusion (CTP). This review compares the performance of 64-slice and 128-slice CT scanners in stroke imaging, focusing on spatial/temporal resolution, acquisition speed, radiation dose, diagnostic accuracy, workflow efficiency, and suitability for resource-limited settings. Evidence suggests that 128-slice CT provides superior temporal resolution, reduced motion artifacts, enhanced CTA and CTP quality, and faster workflow. However, 64-slice scanners remain highly effective for NCCT and routine CTA, offering cost-efficiency and adequate diagnostic accuracy for most emergency stroke pathways.

Keywords

NCCT and routine CTA, offering cost-efficiency and adequate diagnostic accuracy

Downloads

References

1. Wintermark M, Sanelli PC, Albers GW, et al. Imaging recommendations for acute stroke and transient ischemic attack patients. AJNR Am J Neuroradiol. 2013;34(11):E117–E127. [Google Scholar] [Crossref]

2. Boussel L, Wintermark M, Mlynash M, et al. CT perfusion helps predict final infarct size in acute middle cerebral artery stroke. Stroke. 2007;38(4):1315–1320. [Google Scholar] [Crossref]

3. Maas MB, Lev MH, Ay H, et al. CT perfusion imaging in acute stroke. Neuroimaging Clin N Am. 2011;21(2):215–238. [Google Scholar] [Crossref]

4. Bamberg F, Becker A, Schwarz F, et al. Detection of intracranial aneurysms with 64–slice and 128–slice CT angiography: Comparison with digital subtraction angiography. Radiology. 2010;254(2):503–511. [Google Scholar] [Crossref]

5. Nijssen EC, Nelemans PJ, Rennenberg RJ, et al. Prophylaxis in patients at high risk of contrast-induced nephropathy: 64-slice vs 128-slice CTA. Lancet. 2017;389(10076):1312–1322. [Google Scholar] [Crossref]

6. Schulz B, Schmidt D, Beeres M, et al. Low-dose cerebral CT angiography using 128-slice MDCT: Image quality and diagnostic accuracy. Eur Radiol. 2011;21(2):315–323. [Google Scholar] [Crossref]

7. McCollough CH, Leng S, Yu L, Fletcher JG. CT dose reduction and dose management tools: Overview and clinical applications. Radiographics. 2015;35(5):1754–1770. [Google Scholar] [Crossref]

8. Campbell BCV, Ma H, Ringleb PA, et al. Extending thrombolysis to ≥4.5 hours using perfusion imaging. Lancet. 2019;394(10193):139–147. [Google Scholar] [Crossref]

9. Furlan A, Chen D, Bindschadler M, et al. 128-slice MDCT in neurovascular imaging: Technical performance and clinical applications. Clin Radiol. 2015;70(8):e71–e78. [Google Scholar] [Crossref]

10. Lev MH, Farkas J, Rodriguez VR, et al. ASPECTS score reliability with multidetector CT. Stroke. 2001;32(5):1119–1125. [Google Scholar] [Crossref]

11. Riley JD, Derdeyn CP, Grubb RL, Powers WJ. Evaluation of CT perfusion mismatch in ischemic stroke. Stroke. 2011;42(7):2053–2058. [Google Scholar] [Crossref]

12. Zhu G, Michel P, Aghaebrahim A, et al. Optimal acquisition parameters for whole-brain CT perfusion using 128-slice MDCT. AJNR Am J Neuroradiol. 2018;39(2):329–335. [Google Scholar] [Crossref]

13. Bae KT. Intravenous contrast medium administration and scan timing at CT: Considerations and approaches. Radiology. 2010;256(1):32–61. [Google Scholar] [Crossref]

14. González RG. Clinical MRI and CT for the diagnosis of acute ischemic stroke. J Magn Reson Imaging. 2012;36(2):259–271. [Google Scholar] [Crossref]

15. Shah QA, Klufas RA, Heit JJ, et al. 64-slice vs 128-slice CT angiography for distal vessel occlusions. Neuroradiology. 2016;58(5):467–476. [Google Scholar] [Crossref]

Metrics

Views & Downloads

Similar Articles