|
KMID : 1149020170190020069
|
|
Journal of Korean Society of Computed Tomographic Technology
2017 Volume.19 No. 2 p.69 ~ p.82
|
|
|
Evaluation of Usability of Dual Energy When Distinguish Contrast Media from Hemorrhage after Mechanical Thrombectomy in Patients with Acute Ischemic Stroke
|
|
Lee Sang-Hun
Choi Dae-Yeon
Kang Heon-Hyo
Kang Dong-Won
|
|
|
Abstract
|
|
|
Purpose : The purpose of this study is to determine the usability of examination on CT using dual energy (DECT) compared to single energy (SECT) by evaluating diagnostic value of image and radiation dose through distinguishing contrast media from hemorrhage after the mechanical thrombectomy in the patients diagnosed with acute ischemic stroke.
Subjects and Methods : The subjects of this study were 34 patients who were diagnosed with acute ischemic stroke and underwent the intracranial vessel thrombectomy using retrievable stent in the angiography laboratory of Pusan National University, Yangsan Hospital from June 2016 to January 2017. The CT system used in this study are Somatom Definition Flash and Somatom Definition AS+(Siemens Health care, Forchheim, Germany) and the evaluation of distinguishing contrast media from hemorrhage was performed by reconstructing virtual non-contrast images (VNC) and iodine overlay images (IOM) of the acquired data from dual energy using 3-material decomposition algorithms in the 3D-workstation (Syngo MMWP). DLPs (Dose length product) of dual energy CT and single energy CT were compared for the evaluation of radiation dose. Results were analyzed using the paired sample t-test, SPSS version 20 and the statistical significance level was less than 0.05.
Results : 79.4% of the subjects (27/34) showed enhancement by transient blood-brain barrier disruption (BBB disruption), 17.6% (6/34) showed no evidence of unusual complication, and 2.9% (1/34) had hemorrhagic transformation. For the rigorous validation, 24 follow-up examinations were performed. According to the diagnostic value of image which evaluated by the distinction ability contrast media from hemorrhage as very good (4 points) ~ poor (1 point), DECT showed higher diagnostic value than SECT by scoring 3.29 points (DECT) and 2.18 points (SECT) in averagd (p<0.001). DLP of DECT and SECT were 822.39 and 827.00 mGy cm, resepectively and showed no significant difference (p=0.448).
Conclusion : Compared with SECT, DECT is considered the useful examination that can distinguish iodine contrast media from hemorrhage with same dose after the mechanical thrombectomy in the patients with acute ischemic stroke and provides much more diagnostic information.
|
|
|
KEYWORD
|
|
|
Dual energy CT, 3-material decomposition algorithms, Virtual non contrast, Iodine overlay image
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|