Differenziazione tra emorragia cerebrale e stravaso di contrasto mediante tomografia computerizzata a doppia energia dopo procedure neurointerventistiche intra-arteriose

    Publication Date
    Source Authors
    Source Title
    Source Issue
    Publication Date

    2020

    Source Authors

    Zaouak Y.Sadeghi N.Sarbu N.Ligot N.Contro Lubicz B.

     

    Source Title

    Differenziazione tra emorragia cerebrale e stravaso di contrasto mediante tomografia computerizzata a doppia energia dopo procedure neurointerventistiche intra-arteriose

    Source Issue

    European Journal of Radiology

    1

    Page Range: 24

    Lo scopo di quest’articolo è di valutare il valore della tomografia computerizzata a doppia energia (DECT) nel differenziare l’emorragia cerebrale dall’interruzione della barriera ematoencefalica (BBB) ​​dopo procedure neuro-interventistiche con iniezione intraarteriosa di materiale di contrasto iodato. Materiale e metodi: questo studio prospettico è stato approvato dal comitato etico locale e il consenso informato è stato ottenuto per tutti i pazienti. Trentacinque pazienti con ictus ischemico acuto o aneurisma cerebrale non rotto che avevano ricevuto somministrazione intra-arteriosa di materiale di contrasto iodato sono stati valutati utilizzando DECT a 80 e 150 kV immediatamente dopo la procedura. Un algoritmo di decomposizione a tre materiali è stato utilizzato per ottenere immagini virtuali senza contrasto (VNC) e mappe di sovrapposizione di iodio (IOM). Un esame di follow-up (risonanza magnetica cerebrale MRI o TC convenzionale) è stato utilizzato come standard di riferimento per l’emorragia, definita come iperdensità persistente su una TC convenzionale o ipo-intensità T2 * sulla risonanza magnetica cerebrale. Sono stati ottenuti i valori diagnostici di DECT nel differenziare l’emorragia e il mezzo di contrasto iodato. Risultati: le immagini miste ottenute con DECT hanno mostrato iperattenuazione intraparenchimale o subaracnoidea in 18/35 pazienti. Tra questi, 16 sono stati classificati (secondo le immagini VNC e IOM) come stravaso di contrasto e due con una miscela di emorragia e materiale di contrasto. All’imaging di follow-up, c’erano due pazienti con emorragia. La sensibilità, la specificità e l’accuratezza della DECT nell’identificazione dell’emorragia sono state calcolate rispettivamente come 67% (2/3), 100% (32/32) e 97% (32/33).

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