Dual-energy computed tomography in acute ischemic stroke: state-of-the-art

Mangesius, Stephanie; Janjic, Tanja; Steiger, Ruth; Haider, Lukas; Rehwald, Rafael; Knoflach, Michael; Widmann, Gerlig; Gizewski, Elke R.; Grams, Astrid

doi:10.1007/s00330-020-07543-9

Cited by 21 publications

(7 citation statements)

References 58 publications

(100 reference statements)

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“…Recently, dual-energy imaging methods have become increasingly popular in research and clinical practice because of their capability to discriminate between tissues of similar X-ray attenuation but different atomic numbers (15)(16)(17)(18)(19). Dual-energy CT technology is based upon the light-matter interaction and different absorption characteristics of specific substances.…”

Section: Introductionmentioning

confidence: 99%

Value of Dual-Energy Dual-Layer CT After Mechanical Recanalization for the Quantification of Ischemic Brain Edema

et al. 2021

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Background and Purpose: Ischemic brain edema can be measured in computed tomography (CT) using quantitative net water uptake (NWU), a recently established imaging biomarker. NWU determined in follow-up CT after mechanical thrombectomy (MT) has shown to be a strong predictor of functional outcome. However, disruption of the blood–brain barrier after MT may also lead to contrast staining, increasing the density on CT scans, and hence, directly impairing measurements of NWU. The purpose of this study was to determine whether dual-energy dual-layer CT (DDCT) after MT can improve the quantification of NWU by measuring NWU in conventional polychromatic CT images (CP-I) and virtual non-contrast images (VNC-I). We hypothesized that VNC-based NWU (vNWU) differs from NWU in conventional CT (cNWU).Methods: Ten patients with middle cerebral artery occlusion who received a DDCT follow-up scan after MT were included. NWU was quantified in conventional and VNC images as previously published and was compared using paired sample t-tests.Results: The mean cNWU was 3.3% (95%CI: 0–0.41%), and vNWU was 11% (95%CI: 1.3–23.4), which was not statistically different (p = 0.09). Two patients showed significant differences between cNWU and vNWU (Δ = 24% and Δ = 36%), while the agreement of cNWU/vNWU in 8/10 patients was high (difference 2.3%, p = 0.23).Conclusion: NWU may be quantified precisely on conventional CT images, as the underestimation of ischemic edema due to contrast staining was low. However, a proportion of patients after MT might show significant contrast leakage resulting in edema underestimation. Further research is needed to validate these findings and investigate clinical implications.

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Section: Introductionmentioning

confidence: 99%

Value of Dual-Energy Dual-Layer CT After Mechanical Recanalization for the Quantification of Ischemic Brain Edema

et al. 2021

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“…В настоящее время в мире для нейровизуализационной диагностики инсульта на уровне приемного отделения широко применяются две основные методики: КТ и МРТ. Достоинствами КТ является быстрота проведения процедуры (до 15 мин), возможность проведения ее пациентам с металлическими конструкциями и кардиостимуляторами, а также находящимся на ИВЛ, невы-2022;16 (14):32-37 сокая стоимость манипуляции, низкие требования к установке оборудования, высокая точность при проведении дифференциальной диагностики между ишемическим и геморрагическим инсультом [6,7]. Несмотря на преимущества КТ, у этой методики есть свои недостатки, поскольку она не всегда показывает четкий очаг ишемии [8][9][10].…”

Section: Discussionunclassified

What affects the neurovisualisational detection of ischemic stroke?

et al. 2022

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Introduction. The incidence of stroke is 2.5–3 cases per 1 000 population per year, mortality – 1 case per 1 000 population per year. According to various data, up to 20% of computed tomography (CT) scans performed on the first day do not reveal signs of an ischemic focus.Aim of the study. To assess the detectability of acute ischemia foci using CT, depending on the location of the foci, the timing of neuroimaging, the severity of stroke, and other indicators.Material and methods. We analyzed 100 cases of acute cerebrovascular accident (ACV) by ischemic type. The timing of the CT scan, glucose level, coagulogram parameters, NIHSS scores at admission, focus localization, the presence of atherosclerosis of the arteries of the head, and atrial fibrillation were taken into account. Patients were divided into two groups depending on the fact of detection of the focus during the primary tomographic examination. Repeated neuroimaging (magnetic resonance imaging) was performed in 54 patients.Results. In the “CT-negative” group, stem strokes predominated (p = 0.01), patients were younger (р = 0.038), and there were significantly more women than men (р = 0.00006). An increase in glucose over 8 mmol/l, on the contrary, was more often detected in the “CT-positive” group (14 cases in “CT-positive” against 5 cases in “CT-negative” group, p = 0.022). NIHSS scores ≥ 5 were found in 24 patients (47%) in the “CT-positive” group and in 13 patients (26.5%) in the “CT-negative” group (p = 0.034).Conclusions. Cases of stroke that are not detected on CT scan upon admission to the hospital are more common among women, with stem localization, are associated with low NIHSS scores. High glucose levels at admission is associated with the detection of ischemic foci during the initial CT examination.

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“…In cerebrovascular diseases, DECT has shown promise in the evaluation of cerebral hemorrhage, especially in differentiating between active bleeding and hemorrhagic transformation of an ischemic stroke ( 81 ). Although both cerebral hemorrhage and contrast agent extravasation present high-density shadows, they can still be distinguished by DECT according to water-based and iodine-based maps, which is hard for routine CT scans as they both present high-density shadows.…”

Section: Ctmentioning

confidence: 99%

The novel imaging methods in diagnosis and assessment of cerebrovascular diseases: an overview

Liu,

Yao,

Zhu

et al. 2024

Front. Med.

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Cerebrovascular diseases, including ischemic strokes, hemorrhagic strokes, and vascular malformations, are major causes of morbidity and mortality worldwide. The advancements in neuroimaging techniques have revolutionized the field of cerebrovascular disease diagnosis and assessment. This comprehensive review aims to provide a detailed analysis of the novel imaging methods used in the diagnosis and assessment of cerebrovascular diseases. We discuss the applications of various imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and angiography, highlighting their strengths and limitations. Furthermore, we delve into the emerging imaging techniques, including perfusion imaging, diffusion tensor imaging (DTI), and molecular imaging, exploring their potential contributions to the field. Understanding these novel imaging methods is necessary for accurate diagnosis, effective treatment planning, and monitoring the progression of cerebrovascular diseases.

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Dual-energy computed tomography in acute ischemic stroke: state-of-the-art

Cited by 21 publications

References 58 publications

Value of Dual-Energy Dual-Layer CT After Mechanical Recanalization for the Quantification of Ischemic Brain Edema

Value of Dual-Energy Dual-Layer CT After Mechanical Recanalization for the Quantification of Ischemic Brain Edema

What affects the neurovisualisational detection of ischemic stroke?

The novel imaging methods in diagnosis and assessment of cerebrovascular diseases: an overview

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