Application of dual-energy CT immediately in the diagnosis of intracranial hemorrhage after endovascular treatment of acute ischemic stroke

doi:10.3877/cma.j.issn.2095-5782.2021.02.014

Abstract

Abstract:

Objective

To explore the clinical value of DECT in differentiating between intracranial hemorrhage and contrast medium extravasation immediately after endovascular treatment of acute ischemic stroke (AIS).

Methods

50 patients with acute ischemic stroke who underwent endovascular treatment and follow-up DECT immediately were included. Mixed energy images (MIX), virtual non-contrast images (VNC), iodine overlay maps (IOM) and virtual non-calcium images (VNCa) were obtained and evaluated after post-processing. Taking the conventional CT or MR susceptibility weighted angiography (SWAN) images within 24~48 h after operation as the reference standard, the sensitivity, specificity, positive and negative predictive value, accuracy of dual energy CT in the diagnosis of hemorrhage were calculated.

Results

Among the 50 patients, 41 patients had high density on MIX. 29 cases were diagnosed as contrast medium extravasation by DECT, 24 of them were confirmed by follow-up scan, the other 5 cases were identified as hemorrhagic transformation. 12 cases were diagnosed as intracranial hemorrhage complicated with contrast medium extravasation by DECT, all were confirmed by follow-up scan. 10 were diagnosed as atypical calcification by DECT, all were confirmed by follow-up or former scan. The sensitivity, specificity, positive and negative predictive value, accuracy of DECT in the diagnosis of hemorrhage after endovascular treatment of AIS were 70.6% (12/17), 100% (36/36), 100% (12/12), 87.8% (36/41) and 90.6% (48/53), respectively.

Conclusions

DECT can be used to accurately diagnose intracranial hemorrhage immediately after endovascular treatment of AIS.

Key words: Dual-energy CT, Intracranial hemorrhage, Acute ischemic stroke, Virtual non-contrast images, Hemorrhagic transformation

Yue Gu, Yi Zhao, Zhensheng Liu, Hang Qu, Longjiang Zhou, Wei Wang. Application of dual-energy CT immediately in the diagnosis of intracranial hemorrhage after endovascular treatment of acute ischemic stroke[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2021, 09(02): 194-199.

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References 17

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