Yarabe Boniface, Stein Evan G
Department of Radiology, NYU Grossman School of Medicine, 550 1St Ave, New York, NY, 10017, USA.
Emerg Radiol. 2025 Apr;32(2):297-301. doi: 10.1007/s10140-025-02324-7. Epub 2025 Feb 28.
The incidence of chronic subdural hematomas (cSDHs) is rising, leading to an increased reliance on imaging for diagnosis and management. CT imaging is commonly used in the evaluation of these patients, but transient enhancement of chronic subdural collections can mimic acute-on-chronic subdural hematomas, potentially leading to misdiagnosis.
To describe cases of transient enhancement of cSDHs after contrast administration.
A case series of three patients with pre-existing cSDHs was analyzed. One patient underwent middle meningeal artery embolization (MME), and two patients received contrast-enhanced CT (CECT) for other indications. Changes in subdural collection attenuation were assessed on serial imaging.
These three patients with cSDH demonstrated transient enhancement of their subdural collections, which could be mistaken for acute or acute-on-chronic hemorrhage. Recognition of this pattern is critical to avoid misinterpretation, unnecessary radiation exposure, excessive healthcare utilization, and potentially invasive procedures.
Awareness of transient enhancement in chronic subdural collections on CECT is essential for accurate diagnosis. Differentiating this benign imaging artifact from true hemorrhage can prevent unnecessary interventions and optimize patient care.
慢性硬膜下血肿（cSDH）的发病率正在上升，这导致在诊断和治疗中对影像学的依赖增加。CT成像常用于这些患者的评估，但慢性硬膜下积液的短暂强化可模拟慢性硬膜下血肿急性发作，可能导致误诊。
描述造影剂注射后cSDH短暂强化的病例。
分析了一组3例患有cSDH的患者。1例患者接受了脑膜中动脉栓塞术（MME），2例患者因其他适应症接受了增强CT（CECT）检查。通过连续成像评估硬膜下积液衰减的变化。
这3例cSDH患者的硬膜下积液出现短暂强化，可能被误认为急性或慢性硬膜下血肿急性发作。认识到这种模式对于避免误解、不必要的辐射暴露、过度的医疗资源利用以及潜在的侵入性操作至关重要。
认识到CECT上慢性硬膜下积液的短暂强化对于准确诊断至关重要。将这种良性影像学伪影与真正的出血区分开来可以避免不必要的干预并优化患者护理。
