Assessment of post-thrombectomy brain hemorrhage in acute ischemic stroke with dual-energy CT: how reliable is it in clinical practice?
DECT
Neuroradiology
Stroke
Thrombectomy
Journal
La Radiologia medica
ISSN: 1826-6983
Titre abrégé: Radiol Med
Pays: Italy
ID NLM: 0177625
Informations de publication
Date de publication:
17 Feb 2024
17 Feb 2024
Historique:
received:
28
02
2023
accepted:
27
10
2023
medline:
18
2
2024
pubmed:
18
2
2024
entrez:
17
2
2024
Statut:
aheadofprint
Résumé
Acute ischemic stroke is currently among the main causes of mortality in Western countries. The current guidelines suggest different flowcharts of diagnostic work-up and treatment modalities, including endovascular thrombectomy. Immediately after intra-arterial recanalization, a brain CT scan is usually performed to assess for the presence of peri-procedural complications; in this setting, it is very hard, if possible, to differentiate blood from iodinated contrast material, which is normally present in ischemic tissue because of BBB disruption. Dual-energy CT may be used for this purpose, exploiting its ability to discriminate different materials. We retrospectively studied 44 patients with acute ischemic stroke who were treated with endovascular recanalization at San Giovanni Bosco Hospital in Turin and were then scanned with DECT technology. Subsequent scan was used as standard, since iodine from contrast staining is usually reabsorbed in 24 h and blood persists longer. A χ Patients with blood detected on DECT scans had a double chance of having hemorrhagic infarction in follow-up scans, (RR 2.02). The sensitivity and specificity of DECT were respectively 70% and 90%, with an overall diagnostic accuracy of 76% and a positive and negative predictive value, respectively, of 95% and 53%. Dual-energy CT scan after endovascular recanalization in ischemic stroke identifies early hemorrhagic infarction with excellent specificity and good overall diagnostic accuracy, representing a reliable diagnostic tool in everyday clinical practice.
Identifiants
pubmed: 38368280
doi: 10.1007/s11547-023-01749-9
pii: 10.1007/s11547-023-01749-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. Italian Society of Medical Radiology.
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