Residual Thromboembolic Material in Cerebral Arteries after Endovascular Stroke Therapy Can Be Identified by Dual-Energy CT.
نویسندگان
چکیده
BACKGROUND AND PURPOSE Dual-energy CT features the opportunity to differentiate among up to 3 different materials because the absorption of x-rays depends on the applied tube voltage and the atomic number of the material. For example, it is possible to distinguish between blood-brain barrier disruption and an intracerebral hemorrhage following treatment for a stroke. The aim of this study was to evaluate whether dual-energy CT is capable of distinguishing intra-arterial contrast agent from residually clotted vessels immediately after endovascular stroke therapy. MATERIALS AND METHODS Sixteen patients (9 women, 7 men; mean age, 63.6 ± 13.09 years) were examined. Measurements were made on the postinterventional dual-energy CT virtual noncontrast, iodine map, and "weighted" brain window (weighted dual-energy) series. Postinterventional conventional angiography was used as the criterion standard method. RESULTS A residual clot was found in 10 patients. On the virtual noncontrast series, the Hounsfield attenuation of the clotted arteries was higher than that in the corresponding perfused contralateral arteries (53.72 ± 9.42 HU versus 41.64 ± 7.87 HU; P < .05). The latter had higher absorption values on the weighted dual-energy series than on the virtual noncontrast series (49.37 ± 7.44 HU versus 41.64 ± 7.87 HU; P < .05). The sensitivity for the detection of a residual clot was 90%; the specificity was 83.3%, and the accuracy was 87.5%. Interrater agreement was good (κ = 0.733). CONCLUSIONS Dual-energy CT may be valuable in the detection of clot persistence or early re-thrombosis without the necessity of additional contrast administration. However, its relevance for the prediction of outcomes remains to be determined in further studies.
منابع مشابه
Letter by Bosche and Macdonald regarding article, "relevance of blood-brain barrier disruption after endovascular treatment of ischemic stroke: dual-energy computed tomographic study".
BACKGROUND AND PURPOSE Computed tomographic (CT) high attenuation (HA) areas after endovascular therapy for acute ischemic stroke are a common finding indicative of blood-brain barrier disruption. Dual-energy CT allows an accurate differentiation between HA areas related to contrast staining (CS) or to brain hemorrhage (BH). We sought to evaluate the prognostic significance of the presence of C...
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عنوان ژورنال:
- AJNR. American journal of neuroradiology
دوره 36 8 شماره
صفحات -
تاریخ انتشار 2015