Michaël T J Peeters, Alida A Postma, Robert J van Oostenbrugge, Wouter J P Henneman, Julie Staals
{"title":"双能 CT 血管造影在检测脑出血潜在病因中的应用:一项观察性队列研究。","authors":"Michaël T J Peeters, Alida A Postma, Robert J van Oostenbrugge, Wouter J P Henneman, Julie Staals","doi":"10.1007/s00234-024-03473-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>CT angiography (CTA) is often used to detect underlying causes of acute intracerebral hemorrhage (ICH). Dual-energy CT (DECT) is able to distinguish materials with similar attenuation but different compositions, such as hemorrhage and contrast. We aimed to evaluate the diagnostic yield of DECT angiography (DECTA), compared to conventional CTA in detecting underlying ICH causes.</p><p><strong>Methods: </strong>All non-traumatic ICH patients who underwent DECTA (both arterial as well as delayed venous phase) at our center between January 2014 and February 2020 were analyzed. Conventional CTA acquisitions were reconstructed ('merged') from DECTA data. Structural ICH causes were assessed on both reconstructed conventional CTA and DECTA. The final diagnosis was based on all available diagnostic and clinical findings during one-year follow up.</p><p><strong>Results: </strong>Of 206 included ICH patients, 30 (14.6%) had an underlying cause as final diagnosis. Conventional CTA showed a cause in 24 patients (11.7%), DECTA in 32 (15.5%). Both false positive and false negative findings occurred more frequently on conventional CTA. DECTA detected neoplastic ICH in all seven patients with a definite neoplastic ICH diagnosis, whereas conventional CTA only detected four of these cases. Both developmental venous anomalies (DVA) and cerebral venous sinus thrombosis (CVST) were more frequently seen on DECTA. Arteriovenous malformations and aneurysms were detected equally on both imaging modalities.</p><p><strong>Conclusions: </strong>Performing DECTA at clinical presentation of ICH may be of additional diagnostic value in the early detection of underlying causes, especially neoplasms, CVST and DVAs.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"331-338"},"PeriodicalIF":2.4000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893716/pdf/","citationCount":"0","resultStr":"{\"title\":\"Dual-energy CT angiography in detecting underlying causes of intracerebral hemorrhage: an observational cohort study.\",\"authors\":\"Michaël T J Peeters, Alida A Postma, Robert J van Oostenbrugge, Wouter J P Henneman, Julie Staals\",\"doi\":\"10.1007/s00234-024-03473-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>CT angiography (CTA) is often used to detect underlying causes of acute intracerebral hemorrhage (ICH). Dual-energy CT (DECT) is able to distinguish materials with similar attenuation but different compositions, such as hemorrhage and contrast. We aimed to evaluate the diagnostic yield of DECT angiography (DECTA), compared to conventional CTA in detecting underlying ICH causes.</p><p><strong>Methods: </strong>All non-traumatic ICH patients who underwent DECTA (both arterial as well as delayed venous phase) at our center between January 2014 and February 2020 were analyzed. Conventional CTA acquisitions were reconstructed ('merged') from DECTA data. Structural ICH causes were assessed on both reconstructed conventional CTA and DECTA. The final diagnosis was based on all available diagnostic and clinical findings during one-year follow up.</p><p><strong>Results: </strong>Of 206 included ICH patients, 30 (14.6%) had an underlying cause as final diagnosis. Conventional CTA showed a cause in 24 patients (11.7%), DECTA in 32 (15.5%). Both false positive and false negative findings occurred more frequently on conventional CTA. DECTA detected neoplastic ICH in all seven patients with a definite neoplastic ICH diagnosis, whereas conventional CTA only detected four of these cases. Both developmental venous anomalies (DVA) and cerebral venous sinus thrombosis (CVST) were more frequently seen on DECTA. Arteriovenous malformations and aneurysms were detected equally on both imaging modalities.</p><p><strong>Conclusions: </strong>Performing DECTA at clinical presentation of ICH may be of additional diagnostic value in the early detection of underlying causes, especially neoplasms, CVST and DVAs.</p>\",\"PeriodicalId\":19422,\"journal\":{\"name\":\"Neuroradiology\",\"volume\":\" \",\"pages\":\"331-338\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893716/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00234-024-03473-1\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00234-024-03473-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/25 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Dual-energy CT angiography in detecting underlying causes of intracerebral hemorrhage: an observational cohort study.
Background: CT angiography (CTA) is often used to detect underlying causes of acute intracerebral hemorrhage (ICH). Dual-energy CT (DECT) is able to distinguish materials with similar attenuation but different compositions, such as hemorrhage and contrast. We aimed to evaluate the diagnostic yield of DECT angiography (DECTA), compared to conventional CTA in detecting underlying ICH causes.
Methods: All non-traumatic ICH patients who underwent DECTA (both arterial as well as delayed venous phase) at our center between January 2014 and February 2020 were analyzed. Conventional CTA acquisitions were reconstructed ('merged') from DECTA data. Structural ICH causes were assessed on both reconstructed conventional CTA and DECTA. The final diagnosis was based on all available diagnostic and clinical findings during one-year follow up.
Results: Of 206 included ICH patients, 30 (14.6%) had an underlying cause as final diagnosis. Conventional CTA showed a cause in 24 patients (11.7%), DECTA in 32 (15.5%). Both false positive and false negative findings occurred more frequently on conventional CTA. DECTA detected neoplastic ICH in all seven patients with a definite neoplastic ICH diagnosis, whereas conventional CTA only detected four of these cases. Both developmental venous anomalies (DVA) and cerebral venous sinus thrombosis (CVST) were more frequently seen on DECTA. Arteriovenous malformations and aneurysms were detected equally on both imaging modalities.
Conclusions: Performing DECTA at clinical presentation of ICH may be of additional diagnostic value in the early detection of underlying causes, especially neoplasms, CVST and DVAs.
期刊介绍:
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.