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Open Access 01-11-2018 | Computed Tomography

Improved visualisation of early cerebral infarctions after endovascular stroke therapy using dual-energy computed tomography oedema maps

Authors: Astrid Ellen Grams, Tanja Djurdjevic, Rafael Rehwald, Thomas Schiestl, Florian Dazinger, Ruth Steiger, Michael Knoflach, Elke Ruth Gizewski, Bernhard Glodny

Published in: European Radiology | Issue 11/2018

Abstract

Objective

The aim was to investigate whether dual-energy computed tomography (DECT) reconstructions optimised for oedema visualisation (oedema map; EM) facilitate an improved detection of early infarctions after endovascular stroke therapy (EST).

Methods

Forty-six patients (21 women; 25 men; mean age: 63 years; range 24–89 years) were included. The brain window (BW), virtual non-contrast (VNC) and modified VNC series based on a three-material decomposition technique optimised for oedema visualisation (EM) were evaluated. Follow-up imaging was used as the standard for comparison. Contralateral side to infarction differences in density (CIDs) were determined. Infarction detectability was assessed by two blinded readers, as well as image noise and contrast using Likert scales. ROC analyses were performed and the respective Youden indices calculated for cut-off analysis.

Results

The highest CIDs were found in the EM series (73.3 ± 49.3 HU), compared with the BW (-1.72 ± 13.29 HU) and the VNC (8.30 ± 4.74 HU) series. The EM was found to have the highest infarction detection rates (area under the curve: 0.97 vs. 0.54 and 0.90, p < 0.01) with a cut-off value of < 50.7 HU, despite slightly more pronounced image noise. The location of the infarction did not affect detectability (p > 0.05 each).

Conclusions

The EM series allows higher contrast and better early infarction detection than the VNC or BW series after EST.

Key Points

• Dual-energy CT EM allows better early infarction detection than standard brain window.

• Dual-energy CT EM series allow better early infarction detection than VNC series.

• Dual-energy CT EM are modified VNC based on water content of tissue.

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Title: Improved visualisation of early cerebral infarctions after endovascular stroke therapy using dual-energy computed tomography oedema maps
Authors: Astrid Ellen Grams
Tanja Djurdjevic
Rafael Rehwald
Thomas Schiestl
Florian Dazinger
Ruth Steiger
Michael Knoflach
Elke Ruth Gizewski
Bernhard Glodny
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 11/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5449-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Improved visualisation of early cerebral infarctions after endovascular stroke therapy using dual-energy computed tomography oedema maps

Abstract

Objective

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Key Points

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