Maurer Christoph J, Behrens Lars, Schiele Stefan, Zaki Mahmoud, Quint Guilherme, Wolfert Christina, Sommer Björn, Stangl Franz J, Berlis Ansgar
Diagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany.
Computational Statistics and Data Analysis, Institute of Mathematics, University of Augsburg, Augsburg, Germany.
Front Neurol. 2025 May 16;16:1608308. doi: 10.3389/fneur.2025.1608308. eCollection 2025.
Middle meningeal artery embolization is a treatment option for chronic subdural hematoma (cSDH), but data on post-procedural imaging interpretation remain limited. This study investigates whether specific enhancement patterns can predict radiological outcomes and evaluates the utility of photon-counting computed tomography (PCCT) in distinguishing contrast enhancement from hemorrhage.
We retrospectively analyzed 105 cSDHs imaged with either PCCT or flat-panel CT immediately after embolization. Two independent raters assessed enhancement patterns; diagnostic confidence and interrater agreement were evaluated.
PCCT demonstrated higher diagnostic confidence and interrater reliability than flat-panel CT. Internal enhancement and fluid-fluid levels were significantly associated with hematoma persistence or recurrence.
PCCT enhances post-embolization imaging assessment in cSDH. Specific enhancement patterns may serve as imaging biomarkers to identify patients at increased risk for unfavorable radiological outcomes.
脑膜中动脉栓塞术是慢性硬膜下血肿（cSDH）的一种治疗选择，但关于术后影像学解读的数据仍然有限。本研究调查特定的强化模式是否能够预测影像学结果，并评估光子计数计算机断层扫描（PCCT）在区分对比剂强化与出血方面的效用。
我们回顾性分析了105例栓塞术后立即行PCCT或平板CT检查的cSDH病例。两名独立的评估者评估强化模式；评估诊断置信度和评估者间一致性。
与平板CT相比，PCCT显示出更高的诊断置信度和评估者间可靠性。内部强化和液-液平面与血肿持续存在或复发显著相关。
PCCT增强了cSDH栓塞术后的影像学评估。特定的强化模式可作为影像学生物标志物，以识别影像学结果不佳风险增加的患者。
