Diagnostic efficacy of spectral CT virtual non-contrast imaging combined with iodine mapping for differenti-ating early postoperative intracerebral hemorrhage from contrast extravasation after endovascular therapy
10.3969/j.issn.1006-5725.2025.21.022
- VernacularTitle:光谱CT虚拟平扫联合碘图定量鉴别诊断血管内治疗术后早期脑出血与对比剂渗出
- Author:
Yun TAN
1
;
Zhongyi KONG
;
Ximing CAO
;
Zhenbang WANG
;
Junhui ZHENG
;
Wei LUO
Author Information
1. 南方医科大学附属广东省人民医院(广东省医学科学院)放射科(广东 广州 518000)
- Publication Type:Journal Article
- Keywords:
dual-layer spectral CT;
endovascular therapy;
virtual non-contrast;
iodine density map
- From:
The Journal of Practical Medicine
2025;41(21):3449-3454
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the diagnostic value of dual-layer spectral CT(DLCT)virtual non-contrast(VNC)imaging combined with iodine maps in differentiating early post-endovascular therapy(EVT)intracranial hemorrhage from contrast extravasation.Methods Retrospective analysis of 97 patients who underwent DLCT immediately after EVT was conducted.Taking 24-hour follow-up CT/MRI as the gold standard,patients were divided into hemorrhage and non-hemorrhage groups,and their clinical data were compared.VNC CT values and iodine concentration(IC)were measured.Spearman's rank correlation was used to analyze the relationship between VNC CT and IC values,and ROC curve analysis using R software to evaluate the diagnostic performance of VNC,iodine maps,and their combination.Results Among 97 patients,51(52.6%)showed no intracranial hyperdense lesions,while 46(47.4%)with abnormal densities were analyzed.Using 24-hour postoperative CT/MRI as reference stan-dard,among the 46 patients ultimately included in the analysis,38 cases(82.6%)were non-hemorrhagic and 8 cases(17.4%)hemorrhagic.No significant differences existed in age,sex,or treatment methods(all P>0.05).VNC CT values and IC showed significantly negative correlation(r=-0.537,P<0.01).ROC analysis revealed AUCs of 0.917(95%CI:0.786～0.999)for VNC,0.878(95%CI:0.719～0.999)for IC,and 0.919(95%CI:0.812～0.999)for the combination of the two(P<0.05 for combined vs.individual methods).Optimal thresholds were 53.6 HU for VNC and 0.605 mg/ml for IC.Based on the final analysis of 46 enrolled patients,the sensitivity of VNC,iodine map,and their combination in differentiating early cerebral hemorrhage from contrast extravasation was 88.9%,94.3%,and 91.4%,respectively;the specificity 94.3%,77.8%,and 88.9%,respectively;and the accuracy 90.9%,90.9%,and 93.2%,respectively.Conclusion The DLCT VNC-iodine map combination significantly im-proves differentiation between post-EVT hemorrhage and contrast extravasation,and it is recommended for routine clinical application.
