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The role of dual energy CT in differentiating between brain haemorrhage and contrast medium after mechanical revascularisation in acute ischaemic stroke

Abstract

To assess the feasibility of dual energy computed tomography (DE-CT) in intra-arterially treated acute ischaemic stroke patients to discriminate between contrast extravasation and intracerebral haemorrhage. Thirty consecutive acute ischaemic stroke patients following intra-arterial treatment were examined with DE-CT. Simultaneous imaging at 80 kV and 140 kV was employed with calculation of mixed images. Virtual unenhanced non-contrast (VNC) images and iodine overlay maps (IOM) were calculated using a dedicated brain haemorrhage algorithm. Mixed images alone, as ''conventional CT'', and DE-CT interpretations were evaluated and compared with follow-up CT. Eight patients were excluded owing to a lack of follow-up or loss of data. Mixed images showed intracerebral hyperdense areas in 19/22 patients. Both haemorrhage and residual contrast material were present in 1/22. IOM suggested contrast extravasation in 18/22 patients; in 16/18 patients this was confirmed at follow-up. The positive predictive value (PPV) of mixed imaging alone was 25 %, with a negative predictive value (NPV) of 91 % and accuracy of 63 %. The PPV for detection of haemorrhage with DE-CT was 100 %, with an NPV of 89 % and accuracy improved to 89 %. Dual energy computed tomography improves accuracy and diagnostic confidence in early differentiation between intracranial haemorrhage and  More>>
Authors:
Tijssen, M. P.M.; Stadler, A. A.R.; Zwam, W. van; Graaf, R. de; Postma, A. A.; [1]  Hofman, P. A.M.; [1]  Maastricht University, MhENS School for Mental Health and Neuroscience, Maastricht (Netherlands)]; Oostenbrugge, R.J. van; [2]  Maastricht University, CARIM School for Cardiovascular Diseases, P.O. Box 616, Maastricht (Netherlands)]; Klotz, E.; [3]  Wildberger, J. E.; [1]  Maastricht University, CARIM School for Cardiovascular Diseases, P.O. Box 616, Maastricht (Netherlands)]
  1. Maastricht University Medical Centre, Department of Radiology, P.O. Box 5800, Maastricht (Netherlands)
  2. Maastricht University Medical Centre, Department of Neurology, P.O. Box 5800, Maastricht (Netherlands)
  3. Siemens Healthcare Sector, Computed Tomography, Forchheim (Germany)
Publication Date:
Apr 15, 2014
Product Type:
Journal Article
Resource Relation:
Journal Name: European Radiology; Journal Volume: 24; Journal Issue: 4
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; ALGORITHMS; ARTERIES; BLOOD FLOW; BRAIN; COMPARATIVE EVALUATIONS; COMPUTERIZED TOMOGRAPHY; CONTRAST MEDIA; DENSITY; DIAGNOSTIC USES; HEMORRHAGE; IMAGE PROCESSING; IODINE; ISCHEMIA; VASCULAR DISEASES
OSTI ID:
22228609
Country of Origin:
Germany
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0938-7994; CODEN: EURAE3; TRN: DE14F1965049694
Availability:
Available from: http://dx.doi.org/10.1007/s00330-013-3073-x
Submitting Site:
DE
Size:
page(s) 834-840
Announcement Date:
May 22, 2014

Citation Formats

Tijssen, M. P.M., Stadler, A. A.R., Zwam, W. van, Graaf, R. de, Postma, A. A., Hofman, P. A.M., Maastricht University, MhENS School for Mental Health and Neuroscience, Maastricht (Netherlands)], Oostenbrugge, R.J. van, Maastricht University, CARIM School for Cardiovascular Diseases, P.O. Box 616, Maastricht (Netherlands)], Klotz, E., Wildberger, J. E., and Maastricht University, CARIM School for Cardiovascular Diseases, P.O. Box 616, Maastricht (Netherlands)]. The role of dual energy CT in differentiating between brain haemorrhage and contrast medium after mechanical revascularisation in acute ischaemic stroke. Germany: N. p., 2014. Web. doi:10.1007/S00330-013-3073-X.
Tijssen, M. P.M., Stadler, A. A.R., Zwam, W. van, Graaf, R. de, Postma, A. A., Hofman, P. A.M., Maastricht University, MhENS School for Mental Health and Neuroscience, Maastricht (Netherlands)], Oostenbrugge, R.J. van, Maastricht University, CARIM School for Cardiovascular Diseases, P.O. Box 616, Maastricht (Netherlands)], Klotz, E., Wildberger, J. E., & Maastricht University, CARIM School for Cardiovascular Diseases, P.O. Box 616, Maastricht (Netherlands)]. The role of dual energy CT in differentiating between brain haemorrhage and contrast medium after mechanical revascularisation in acute ischaemic stroke. Germany. https://doi.org/10.1007/S00330-013-3073-X
Tijssen, M. P.M., Stadler, A. A.R., Zwam, W. van, Graaf, R. de, Postma, A. A., Hofman, P. A.M., Maastricht University, MhENS School for Mental Health and Neuroscience, Maastricht (Netherlands)], Oostenbrugge, R.J. van, Maastricht University, CARIM School for Cardiovascular Diseases, P.O. Box 616, Maastricht (Netherlands)], Klotz, E., Wildberger, J. E., and Maastricht University, CARIM School for Cardiovascular Diseases, P.O. Box 616, Maastricht (Netherlands)]. 2014. "The role of dual energy CT in differentiating between brain haemorrhage and contrast medium after mechanical revascularisation in acute ischaemic stroke." Germany. https://doi.org/10.1007/S00330-013-3073-X.
@misc{etde_22228609,
title = {The role of dual energy CT in differentiating between brain haemorrhage and contrast medium after mechanical revascularisation in acute ischaemic stroke}
author = {Tijssen, M. P.M., Stadler, A. A.R., Zwam, W. van, Graaf, R. de, Postma, A. A., Hofman, P. A.M., Maastricht University, MhENS School for Mental Health and Neuroscience, Maastricht (Netherlands)], Oostenbrugge, R.J. van, Maastricht University, CARIM School for Cardiovascular Diseases, P.O. Box 616, Maastricht (Netherlands)], Klotz, E., Wildberger, J. E., and Maastricht University, CARIM School for Cardiovascular Diseases, P.O. Box 616, Maastricht (Netherlands)]}
abstractNote = {To assess the feasibility of dual energy computed tomography (DE-CT) in intra-arterially treated acute ischaemic stroke patients to discriminate between contrast extravasation and intracerebral haemorrhage. Thirty consecutive acute ischaemic stroke patients following intra-arterial treatment were examined with DE-CT. Simultaneous imaging at 80 kV and 140 kV was employed with calculation of mixed images. Virtual unenhanced non-contrast (VNC) images and iodine overlay maps (IOM) were calculated using a dedicated brain haemorrhage algorithm. Mixed images alone, as ''conventional CT'', and DE-CT interpretations were evaluated and compared with follow-up CT. Eight patients were excluded owing to a lack of follow-up or loss of data. Mixed images showed intracerebral hyperdense areas in 19/22 patients. Both haemorrhage and residual contrast material were present in 1/22. IOM suggested contrast extravasation in 18/22 patients; in 16/18 patients this was confirmed at follow-up. The positive predictive value (PPV) of mixed imaging alone was 25 %, with a negative predictive value (NPV) of 91 % and accuracy of 63 %. The PPV for detection of haemorrhage with DE-CT was 100 %, with an NPV of 89 % and accuracy improved to 89 %. Dual energy computed tomography improves accuracy and diagnostic confidence in early differentiation between intracranial haemorrhage and contrast medium extravasation in acute stroke patients following intra-arterial revascularisation. (orig.)}
doi = {10.1007/S00330-013-3073-X}
journal = []
issue = {4}
volume = {24}
journal type = {AC}
place = {Germany}
year = {2014}
month = {Apr}
}