Department of Radiology, Massachusetts General Hospital, Neuroradiology GRB-273A, Boston, MA 02114, USA.
Radiology. 2010 Oct;257(1):205-11. doi: 10.1148/radiol.10091806. Epub 2010 Aug 2.
To evaluate the efficacy of dual-energy computed tomography (CT) in the differentiation of intracerebral hemorrhage (ICH) from iodinated contrast material in patients who received contrast material via intraarterial or intravenous delivery.
This retrospective study was approved by the local institutional review board, which waived the informed consent requirement for the analysis. Sixteen patients with acute stroke and two with head trauma who had undergone intraarterial or intravenous administration of iodinated contrast material were evaluated by using dual-energy CT to differentiate areas of hyperattenuation secondary to contrast material staining from those representing ICH. A dual-energy CT scanner was used for imaging at 80 and 140 kV, and a three-material decomposition algorithm was used to obtain virtual unenhanced images and iodine overlay images. The sensitivity, specificity, and accuracy of dual-energy CT in the prospective differentiation of intraparenchymal contrast material from hemorrhage were obtained. Follow-up images were used as the standard of reference.
There were 28 intraparenchymal areas of hyperattenuation classified at dual-energy CT as iodinated contrast material staining (n = 20, 71%), hemorrhage (n = 5, 18%), or both (n = 3, 11%). Two of the three areas of hyperattenuation seen on both virtual unenhanced and iodine overlay images were related to mineralization. The sensitivity, specificity, and accuracy of dual-energy CT in the identification of hemorrhage were 100% (six of six areas), 91% (20 of 22 areas), and 93% (26 of 28 areas), respectively.
Dual-energy CT can help differentiate ICH from iodinated contrast material staining with high sensitivity and specificity in patients who have recently received intraarterial or intravenous iodinated contrast material.
评估双能 CT 在区分经动脉或静脉内给予碘造影剂的患者的脑内出血（ICH）与碘造影剂染色方面的疗效。
本回顾性研究获得了当地机构审查委员会的批准，该委员会豁免了分析的知情同意要求。对 16 例急性脑卒中患者和 2 例头部外伤患者进行了双能 CT 检查，以区分继发于造影剂染色的高衰减区与代表 ICH 的区域。使用双能 CT 扫描仪以 80kV 和 140kV 进行成像，并使用三物质分解算法获得虚拟未增强图像和碘覆盖图像。获得了双能 CT 对脑实质内造影剂与出血的前瞻性区分的敏感性、特异性和准确性。随访图像被用作参考标准。
双能 CT 将 28 个脑实质内高衰减区分类为碘造影剂染色（n=20，71%）、出血（n=5，18%）或两者兼有（n=3，11%）。在虚拟未增强和碘覆盖图像上均可见的 3 个高衰减区中的 2 个与矿化有关。双能 CT 对出血的识别的敏感性、特异性和准确性分别为 100%（6/6 个区域）、91%（20/22 个区域）和 93%（26/28 个区域）。
双能 CT 可在近期接受动脉内或静脉内碘造影剂的患者中，以较高的敏感性和特异性帮助区分 ICH 与碘造影剂染色。
