AUTHOR=Liu Keqin , Jiang Lin , Ruan Jie , Xia Wenqing , Huang Huan , Niu Guozhong , Yan Shenqiang , Yin Congguo 

TITLE=The Role of Dual Energy CT in Evaluating Hemorrhagic Complications at Different Stages After Thrombectomy

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.583411

DOI=10.3389/fneur.2020.583411

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> Contrast media extravasation can mimic hemorrhage after endovascular thrombectomy (EVT). Dual energy CT (DECT) has the potential to distinguish hemorrhage from iodine contrast.</p><p><bold>Methods:</bold> We retrospectively examined clinical and radiological data from 106 consecutive acute ischemic stroke patients who received EVT and underwent DECT immediately and 24 h after EVT. Iodine overlay map, virtual non-contrast, and mixed images are reconstructed.</p><p><bold>Results:</bold> With the use of DECT, the proportion of all patients diagnosed with hemorrhagic transformation on mixed images immediately after EVT was reduced from 74.5% (79 of 106) to 10.4% (11 of 106), with a very poor consistency (κ = 0.076, <italic>p</italic> = 0.041). Correspondingly, hemorrhagic transformation on mixed images 24 h after EVT was reduced from 41.5% (44 of 106) to 30.2% (32 of 106), with a moderate consistency (κ = 0.757, <italic>p</italic> &lt; 0.001).</p><p><bold>Conclusions:</bold> The use of DECT both immediately and 24 h after EVT changes the diagnosis of hemorrhagic transformation in a considerable proportion of acute ischemic stroke patients with EVT. This could affect decision making with respect to antithrombotic strategy.</p>