Details

Autor(en) / Beteiligte

• Wang, Zhenshan
• Chen, Wanqi
• Lin, Haitao
• Luo, Shiwei
• Liu, Yuan
• Lin, Yang
• Tao, Ying
• Huang, Weipeng

Titel

Early diagnosis and prediction of intracranial hemorrhage using dual-energy computed tomography after mechanical thrombectomy in patients with acute ischemic stroke

Ist Teil von

• Clinical neurology and neurosurgery, 2021-04, Vol.203, p.106551-106551, Article 106551

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2021

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• •Mechanical thrombectomy gradually embodies its value in the treatment of AIS patients, and more rapid and accurate methods are needed for the evaluation of surgical effect and prognosis judgment.•DECT scanning has been innovatively added to the early diagnosis of AIS patients after mechanical thrombectomy to obtain the information of bleeding.•The patients with high iodine concentration should be given enough attention and early intervention. There is a significant correlation between iodine concentration and prognosis in patients with bleeding.. This study assesses the clinical value of dual-energy computed tomography (DECT) in the early diagnosis of intracranial hemorrhage and evaluates the risk of hemorrhagic transformation in patients with acute ischemic stroke (AIS) after mechanical thrombectomy. Patients with AIS who have undergone thrombectomy with Solitaire stent and DECT within one hour after surgery were prospectively enrolled. Linear mixed energy images, virtual non-contrast (VNC) image, and iodine overlay map (IOM) were obtained. Routine CT scan was performed 24 h postoperatively. The sensitivity, specificity, positive and negative predictive values, and accuracy of DECT in the early diagnosis of intracranial hemorrhage was evaluated. The iodine concentration of intracranial lesions was measured by IOM with the follow-up results taken as reference. Receiver operating characteristic (ROC) analysis was performed to obtain the threshold of hemorrhagic transformation and increased bleeding. Among the 44 patients enrolled in this study, 25 (56.8 %) were diagnosed with simple extravasation of iodinated contrast agent, and 19 (43.2 %) showed intracranial hemorrhage in DECT. Compared with the follow-up CT 24 h after surgery, early diagnosis of postoperative intracranial hemorrhage using DECT demonstrated a sensitivity of 90.5 %, specificity of 100 %, positive predictive rate of 100 %, negative predictive rate of 92.0 %, and accuracy of 95.5 %. Among the 86 intracranial lesions that underwent iodine concentration measurement, 19 were diagnosed with hemorrhagic transformation or increased bleeding, and 67 were diagnosed without the aforementioned conditions. The sensitivity and specificity for differentiating the two groups were 73.7 % and 92.5 %, respectively, with a cut-off value of 2.7 mg/mL. DECT is clinically valuable in early diagnosis and prediction of intracranial hemorrhage after mechanical thrombectomy in AIS patients.