Unenhanced Dual-Energy Computed Tomography

Mohammed, Mohammed F.; Marais, Olivia; Min, Adam; Ferguson, David W.; Jalal, Sabeena; Khosa, Faisal; O’Keeffe, Michael E.; O’Connell, Tim W.; Schmiedeskamp, Heiko; Krauß, Bernhard; Rohr, Axel; Nicolaou, Savvas

doi:10.1097/rli.0000000000000413

Cited by 49 publications

(34 citation statements)

References 41 publications

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“…39 On the other hand, CT signs of brain swelling without concomitant parenchymal hypoattenuation in patients with acute cerebral ischemia may suggest ischemic penumbral or oligemic tissue as evaluated by diffusion and perfusion studies. 40 Methods to differentiate between infarct volume and perilesional edema using CT include identifying net water uptake 41,42 and dual-energy CT. 43 In our study, perilesional edema was differentiated from ischemic areas by comparing MRI diffusion weighted imaging with CT as has been demonstrated before. 44,45 As penumbra cannot be differentiated from edema beyond doubt, 44,45 it was considered a part of the edema.…”

Section: Focal Cerebral Ischemiamentioning

confidence: 77%

CT‐Based Classification of Acute Cerebral Edema: Association with Intracranial Pressure and Outcome

Zausinger

Patzig

Kunz

2020

Journal of Neuroimaging

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BACKGROUND AND PURPOSE: Brain edema after acute cerebral lesions may lead to raised intracranial pressure (ICP) and worsen outcome. Notwithstanding, no CT-based scoring system to quantify edema formation exists. This retrospective correlative analysis aimed to establish a valid and definite CT score quantifying brain edema after common acute cerebral lesions. METHODS: A total of 169 CT investigations in 60 patients were analyzed: traumatic brain injury (TBI; n = 47), subarachnoid hemorrhage (SAH; n = 70), intracerebral hemorrhage (ICH; n = 42), and ischemic stroke (n = 10). Edema formation was classified as 0: no edema, 1: focal edema confined to 1 lobe, 2: unilateral edema > 1 lobe, 3: bilateral edema, 4: global edema with disappearance of sulcal relief, and 5: global edema with basal cisterns effacement. ICP and Glasgow Outcome Score (GOS) were correlated to edema formation.

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Section: Focal Cerebral Ischemiamentioning

confidence: 77%

CT‐Based Classification of Acute Cerebral Edema: Association with Intracranial Pressure and Outcome

Zausinger

Patzig

Kunz

2020

Journal of Neuroimaging

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“…It showed that the X-Map (brain edema image) is able to detect edema and measure the end-infarct (core infarct) volume more accurately than conventional CT does. The sensitivity, specificity, positive predictive value, and negative predictive value of the X-Map (brain edema image) were 93.3, 100, 100, and 91.7%, respectively, while those of conventional CT were 80, 72.7, 80, and 72.7%, respectively [29].…”

Section: X-map Algorithmmentioning

confidence: 94%

“…The study found that acute infarctions delineated by the X-Map agreed very well with those by diffusion-weighted images, including ischemic regions that recovered after treatments. Another study [29] compared X-Map (brain edema image) with conventional CT using a 24-h follow-up CT as the gold standard. Mohammed et al called these processed images brain edema images.…”

Section: X-map Algorithmmentioning

confidence: 99%

Dual energy computed tomography for the head

2017

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Dual energy CT (DECT) is a promising technology that provides better diagnostic accuracy in several brain diseases. DECT can generate various types of CT images from a single acquisition data set at high kV and low kV based on material decomposition algorithms. The two-material decomposition algorithm can separate bone/calcification from iodine accurately. The three-material decomposition algorithm can generate a virtual non-contrast image, which helps to identify conditions such as brain hemorrhage. A virtual monochromatic image has the potential to eliminate metal artifacts by reducing beam-hardening effects. DECT also enables exploration of advanced imaging to make diagnosis easier. One such novel application of DECT is the X-Map, which helps to visualize ischemic stroke in the brain without using iodine contrast medium.

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“…To improve treatment, some studies have used Dual-energy CT to predict lesions [7,8], which is based on high and low peak voltage acquisitions, but is presently not conducted in China. There are also studies that have detected damaged brain tissue early after cerebral ischemia using multimodal CT techniques (CT angiography and CT perfusion, with source images) [9,10], which have been shown to have similar sensitivity to MRI [8]. However, none of these methods are as convenient and as easy to use as noncontrast CT (ncCT).…”

Section: Introductionmentioning

confidence: 99%

White Matter High Signals Interfere with Noncontrast Computed Tomography in the Early Identification of Cerebral Infarction

Lin

Li²,

et al. 2020

Cerebrovasc Dis

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Background:We developed an image patch classificationbased method to detect early ischemic stroke. The accuracy of this method was > 75%. We aimed to analyze patients' image data to identify interference factors that would affect its accuracy. Methods: We conducted a retrospective analysis of 162 patients who were hospitalized with acute ischemic stroke. Factors related to the noncontrast computed tomography (ncCT) determination results were analyzed according to the patient's sex, age, clinical symptoms, cerebral infarction volume, cerebral infarction location, and whether or not the white matter high (WMH) signal was combined. Results: The volume of cerebral infarction was positively correlated with the predicted results. The correct percentages of patients with volumes > 1 and < 1 mL were 59.18 and 83.19%, respectively, and the difference was statistically significant (p = 0.001). The correct percentage of the internal capsule region (47.1%) was significantly lower than that of the other groups (p = 0.011). The correct percentage of lateral ventricular paraventricular infarction was significantly lower than that of non-lateral ventricle patients (70.8 vs. 85.7%). In patients with lateral ventricular paraventricular infarction, if the WMH was combined, the correct percentage will decreased further as the Fazekas level increased. The correct percentage of lateral ventricle infarction combined with Fazekas 3 was 40.0%, which was statistically significant compared with the patient having Fazekas 0 with lateral ventricular infarction (p = 0.01). Conclusions: WMH had a similar computed tomography appearance to cerebral infarction and could interfere with the prediction of the cerebral infarction region by ncCT. This result provides a reference for clinicians to choose imaging methods for identifying acute cerebral infarction areas.

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Unenhanced Dual-Energy Computed Tomography

Abstract: Brain edema reconstructions are able to more accurately detect edema and end-infarct volume as compared with initial TNC images. This provides a better assessment of the degree and extent of infarction and may serve to better guide therapy in the future.

Cited by 49 publications

References 41 publications

CT‐Based Classification of Acute Cerebral Edema: Association with Intracranial Pressure and Outcome

CT‐Based Classification of Acute Cerebral Edema: Association with Intracranial Pressure and Outcome

Dual energy computed tomography for the head

White Matter High Signals Interfere with Noncontrast Computed Tomography in the Early Identification of Cerebral Infarction

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