Evaluation value of dualGenergy CT in intracranial hemorrhage after mechanical thrombectomy for stroke / 实用放射学杂志

ABSTRACT

Objective To investigate the value of dual-energy CT in differentiating intracranial hemorrhage (ICH)from extravasation of contrast medium in patients with acute ischemic stroke (AIS)after mechanical thrombectomy.Methods AIS patients who underwent mechanical thrombectomy from January 2018 to July 2018 were prospectively included.They all underwent dual-energy CT immediately within 1 h after surgery.Virtual non-contrast (VNC),iodine overlay maps (IOM)and mixed energy images (MIX)were obtained and evaluated respectively. Follow-up was performed 48 hours after surgery with dual-energy CT,which was used as a reference standard and compared with the previous evaluation results.Results Among the 34 patients with complete data,6 cases had no obvious high-density shadow on the MIX image.Among the remaining 28 patients with high-density shadow,14 cases had immediate dual-energy CT diagnosis of bleeding,all of which were confirmed as bleeding during follow-up.Twelve cases were diagnosed as extravasation of contrast medium,of which 1 case had secondary hemorrhage transformation during follow-up,and the rest were all extravasation of contrast medium.Two cases were diagnosed as bleeding with extravasation,and both were confirmed during follow-up.The sensitivity was 93%.The specificity was 1 00%.The positive predictive value was 1 00%.The negative predictive value was 9 2% (P＜ 0.05).Conclusion Dual-energy CT can accurately differentiate ICH from extravasation of contrast agent in AIS patients after mechanical thrombectomy,which is of great value in ICH evaluation after surgery.