Significance of simulated conventional images on dual energy CT after endovascular treatment for ischemic stroke
Significance of simulated conventional images on dual energy CT after endovascular treatment for ischemic stroke
复制标题
DOI：
10.1136/neurintsurg-2018-014486
复制
发表时间：
2019-09-01
影响因子：
4.8
通讯作者：
Abe, Tatsuya
中科院分区：
文献类型：
--
作者：
Ebashi, Ryo;Ogata, Atsushi;Abe, Tatsuya
背景和目的CT扫描经常显示介入后脑高密度（PCHDs）在动脉内血栓切除术（IAT）后立即。双能CT （DE-CT）可提示PCHDs是由出血还是碘化造影剂引起。使用碘化造影剂在DE-CT上检测到的高密度病变可能与出血转化延迟和预后不良有关。然而，DE-CT预测迟发性出血转化的定量指标尚不清楚。我们评估了这些预测延迟出血转化的指标。材料与方法回顾性分析52例连续行IAT治疗的急性缺血性脑卒中患者。模拟常规CT （sCCT）图像在DE-CT扫描后立即获得。重建后进行虚拟、非增强、非对比（VNC）成像。测量sCCT上梗死区域的霍斯菲尔德单位（Hounsfield units， HU）。评估sCCT上的HU与VNC出血和延迟性实质出血（PH）的关系。结果伴有VNC出血的sCCT HU明显高于无VNC出血的sCCT (377.9 +/- 385 HU vs 83.5 +/- 37.9 HU
Background and purpose CT scans often reveal post-interventional cerebral hyperdensities (PCHDs) immediately after intra-arterial thrombectomy (IAT) for ischemic stroke. Dual energy CT (DE-CT) can indicate whether PCHDs are caused by hemorrhage or iodinated contrast. Hyperdense lesions, detected on DE-CT with the use of iodinated contrast, could be associated with delayed hemorrhagic transformation and poor outcome. However, the quantitative indicators in DE-CT for predicting delayed hemorrhagic transformation remain unclear. We assessed such indicators for predicting delayed hemorrhagic transformation.Material and methods We retrospectively analyzed 52 consecutive acute ischemic stroke patients who underwent IAT. Simulated conventional CT (sCCT) images were obtained immediately after a DE-CT scan. Virtual, unenhanced, non-contrast (VNC) imaging was performed after reconstruction. Hounsfield units (HU) of the infarct areas observed on the sCCT were measured. The association of HU on sCCT with hemorrhage on VNC and delayed parenchymal hemorrhage (PH) was evaluated. Results The HU of sCCT with hemorrhage on VNC was significantly higher than without it (377.9 +/- 385 HU vs 83.5 +/- 37.9 HU; P