The Role of Dual Energy CT in Evaluating Hemorrhagic Complications at Different Stages After Thrombectomy
Keqin Liu, Lin Jiang, Jie Ruan, Wenqing Xia, Huan Huang, Guozhong Niu, Shenqiang Yan, Congguo Yin
Abstract
Background: Contrast medium extravasation can mimic hemorrhage after endovascular thrombectomy (EVT). Dual energy CT (DECT) has potential to distinguish hemorrhage from iodine contrast. Methods: We retrospectively examined clinical and radiological data from 106 consecutive acute ischemic stroke patients who received EVT and underwent DECT immediately and 24 hours after EVT. Iodine overlay map, virtual non-contrast and mixed images are reconstructed. Results: With the use of DECT, the proportion of all patients diagnosed with hemorrhagic transformation on mixed images immediately after EVT was reduced from 74.5% (79 of 106) to 10.4% (11 of 106), with a very poor consistency (κ = 0.076, p = 0.041). Correspondingly, hemorrhagic transformation on mixed images 24 hours after EVT was reduced from 41.5% (44 of 106) to 30.2% (32 of 106), with a moderate consistency (κ = 0.757, p < 0.001). Conclusions: Both DECT immediately and 24 hours after EVT changes the diagnosis of hemorrhagic transformation in a considerable proportion of acute ischemic stroke patients with EVT. This could affect decision-making of antithrombotic strategy.