Third generation dual-source CT in early differential diagnosis of intracranial hemorrhage and iodinated contrast medium after endovascular treatment of acute ischemic stroke patients
10.13929/j.1003-3289.201708075
- VernacularTitle:第三代双源CT早期鉴别诊断急性缺血性脑卒中患者血管内治疗后颅内出血灶与碘对比剂
- Author:
Fang WU
1
;
Xiangying DU
;
Miao ZHANG
;
Qi YANG
;
Xiaolian ZHU
;
Jie LU
Author Information
1. 首都医科大学宣武医院放射科
- Keywords:
Acute ischemic stroke;
Endovascular treatment;
Intracranial hemorrhage;
Tomography,X-ray computed
- From:
Chinese Journal of Medical Imaging Technology
2018;34(5):770-774
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of third generation dual-source CT in early differential diagnosis of intracranial hemorrhage and iodinated contrast medium after endovascular treatment of acute ischemic stroke (AIS).Methods Totally 78 patients with AIS underwent endovascular treatment were prospectively enrolled.Dual-energy CT (DECT) examination (80 kV/Sn150 kV) of the head was performed after treatment with a third generation dual-source CT scanner.Iodine overlay maps and virtual non-contrast images were post-processed.Taking conventional brain CT images obtained 24 48 h after AIS attack as references,the accuracy,sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of DECT for identifying hemorrhage were computed respectively.Results Totally 31 patients with 53 foci of intracranial hyper-attenuation were finally enrolled.Among 53 foci,26 were correctly diagnosed as hemorrhage by DECT,23 were correctly diagnosed as iodinated contrast medium,while 1 calcification was misdiagnosed as hemorrhage combined with iodinated contrast medium,3 were misdiagnosed as contrast medium which showed delayed hemorrhagic transformation.The sensitivity,specificity and accuracy of DECT was 89.66％ (26/29),95.83％ (23/24) and 92.45％ (49/53),PPV and NPV was 96.30％ (26/27) and 88.46％ (23/26),respectively.Conclusion The third generation dual-source CT is available in early and accurate diagnosis of hemorrhagic transformation after endovascular treatment of AIS,which can help clinicians to adjust the subsequent treatment strategies in time.
