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Dual-energy CT for detection of contrast enhancement or leakage within high-density haematomas in patients with intracranial haemorrhage

  • Diagnostic Neuroradiology
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Abstract

Introduction

Our study aimed to elucidate the diagnostic performance of dual-energy CT (DECT) in the detection of contrast enhancement in intracranial haematomas (ICrH) with early phase dual-energy computed tomography angiography (CTA) and compare the results with those obtained by delayed CT enhancement.

Methods

Thirty-six patients with ICrH were retrospectively included in this study. All patients had undergone single-energy non-contrast CT and contrast-enhanced dual-source DECT. DECT images were post-processed with commercial software, followed by obtaining iodine images and virtual non-contrast images and generating combined images that created the impression of 120-kVp images. Two neuroradiologists, blinded to the patients’ data, reviewed two reading sessions: session A (non-contrast CT and combined CT) and session B (non-contrast CT, combined CT, and iodine images) for detection of contrast enhancement in the haematomas.

Results

Contrast leakage or enhancement was detected in 23 (57.5 %) out of 40 haemorrhagic lesions in 36 patients on delayed CT. Three enhanced lesions were depicted only in the DECT iodine images. The sensitivity, specificity, positive predictive value, and negative predictive value of session A were 82.6, 94.1, 95.0, and 80.0 %, respectively, and those of session B were 95.7, 94.1, 95.7, and 94.1 %, respectively.

Conclusion

DECT emphasised the iodine enhancement and facilitated the detection of contrast enhancement or leakage.

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Abbreviations

ICrH:

Intracranial haematoma

ICeH:

Intracerebral haematoma

DECT:

Dual-energy CT

ROI:

Region of interest

PPV:

Positive predictive value

NPV:

Negative predictive value

HU:

Hounsfield units

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Yoshiyuki Watanabe, Akio Tsukabe, Yuki Kunitomi, Mitsuo Nishizawa, Atsuko Arisawa, Hisashi Tanaka & Noriyuki Tomiyama

  2. Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

    Kazuhisa Yoshiya & Takeshi Shimazu

Authors
  1. Yoshiyuki Watanabe
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  2. Akio Tsukabe
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  3. Yuki Kunitomi
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  4. Mitsuo Nishizawa
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  5. Atsuko Arisawa
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  6. Hisashi Tanaka
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  7. Kazuhisa Yoshiya
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  8. Takeshi Shimazu
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  9. Noriyuki Tomiyama
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Corresponding author

Correspondence to Yoshiyuki Watanabe.

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Watanabe, Y., Tsukabe, A., Kunitomi, Y. et al. Dual-energy CT for detection of contrast enhancement or leakage within high-density haematomas in patients with intracranial haemorrhage. Neuroradiology 56, 291–295 (2014). https://doi.org/10.1007/s00234-014-1333-3

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  • DOI: https://doi.org/10.1007/s00234-014-1333-3

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