• Line Bentsen, Anders Christensen, Inger Havsteen, Hanne Hansen, Christian Ovesen, and Hanne Christensen.
• Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark. Electronic address: Line.Bentsen@regionh.dk.
• J Stroke Cerebrovasc Dis. 2015 May 1; 24 (5): 1008-12.

BackgroundIncidental findings of suspect lung opacities are common in computed tomography (CT)-based thorax examinations, especially in high-risk patients, such as stroke patients. Screening with CT of the thorax has detected lung cancer in approximately .31%-1.20% of high-risk populations. The aim of the present study was to report the frequency of suspect lung opacities on routine acute stroke imaging.MethodsSeven hundred and fifty-seven consecutive stroke patients evaluated for intravenous thrombolysis treatment within 4.5 hours of symptom debut, from June 2009 to December 2011, were included in a prospective registry on which this analysis was based. On admission, CT angiography from the aortic arch to vertex was performed, including the lung apices, corresponding to 1/3 of the total lung volume. A senior neuroradiologist reviewed all scans registering suspect lung opacities, which subsequently were characterized as either malignant, presumed malignant, presumed benign or benign, based on radiologic parameters of malignancy, positron emission tomography scan, histology, and clinical features.ResultsSuspect lung opacities appeared on the CT angiography in 20 patients (2.6%). Five suspect lung opacities were categorized as malignant and 3 suspect lung opacities were categorized as presumed malignant. This corresponds to an incidence of 1.1% (8 of 750).ConclusionsMalignant lung opacities were found in approximately 1% of this high-risk population, whereas our findings do not support full CT of the thorax as routine on stroke patients.Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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