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

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.