Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Residual Thromboembolic Material in Cerebral Arteries after Endovascular Stroke Therapy Can Be Identified by Dual-Energy CT

Residual Thromboembolic Material in Cerebral Arteries after Endovascular Stroke Therapy Can Be... 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. ABBREVIATIONS: CI confidence interval DECT dual-energy CT DEw weighted dual-energy series IM iodine map series VNC virtual noncontrast series http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Residual Thromboembolic Material in Cerebral Arteries after Endovascular Stroke Therapy Can Be Identified by Dual-Energy CT

Loading next page...
 
/lp/american-journal-of-neuroradiology/residual-thromboembolic-material-in-cerebral-arteries-after-1P0TUbXX5m
Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2015 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A4350
pmid
25999414
Publisher site
See Article on Publisher Site

Abstract

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. ABBREVIATIONS: CI confidence interval DECT dual-energy CT DEw weighted dual-energy series IM iodine map series VNC virtual noncontrast series

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Aug 1, 2015

There are no references for this article.