Cerebral Contrast Staining on Dual-Energy CT after Coil Embolization of Unruptured Intracranial Aneurysms: Frequency, Risk Factors, and Clinical Implications.

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-03-25 DOI:10.1016/j.wneu.2025.123930

Byeong-Su Park, Jung Hoon Han, Won Ki Yoon, Sang-Il Suh

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引用次数: 0

Abstract

Objective: Cerebral contrast staining (CCS) post-endovascular procedures may mimic subarachnoid hemorrhage. This study investigates CCS frequency and risk factors using dual-energy computed tomography (DECT) following coil embolization of unruptured intracranial aneurysms.

Methods: A retrospective analysis included 232 patients undergoing coil embolization and immediate DECT imaging between October 2018 and March 2023. CCS was defined as hyperattenuation on iodine overlay images absent on virtual non-contrast images. Logistic regression identified predictors of CCS.

Results: CCS occurred in 95 patients (40.9%), predominantly in anterior circulation aneurysms (48.1%) compared to posterior circulation (14.3%, p = 0.001). High CCS rates occurred particularly in posterior communicating (59.1%) and anterior communicating/anterior cerebral artery aneurysms (59.0%). Low-osmolar contrast media had higher CCS incidence (56.4%) compared to iso-osmolar media (30.4%, p < 0.001). CCS-positive patients had higher contrast volume (186.35 ± 46.62 mL vs. 171.62 ± 34.89 mL; p = 0.009) and longer procedures (158.41 ± 41.25 vs. 135.28 ± 35.07 min, p < 0.001). Multivariate analysis identified posterior communicating artery aneurysms, low-osmolar contrast media, procedure duration, and contrast volume as independent CCS predictors. Demographic factors and blood pressure variability were unrelated. One transient contrast-induced encephalopathy case occurred; no hemorrhages were identified.

Conclusions: CCS is common after coil embolization, especially with longer procedures, anterior aneurysms, and low-osmolar contrast media. DECT effectively differentiates CCS from hemorrhage, potentially reducing unnecessary follow-up imaging.

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS