Virtual monoenergetic dual-energy CT reconstructions at 80 keV are optimal non-contrast CT technique for early stroke detection
| Autor: | Zoran Rumboldt, Zrinka Matana Kaštelan, Doris Dodig, Damir Miletić, Nina Bartolović, Slaven Jurković |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.diagnostic_test
Brain edema business.industry Non contrast ct Virtual monoenergetic imaging Brain Edema Computed tomography Original Articles General Medicine medicine.disease Stroke dual energy CT virtual monoenergetic imaging Brain Ischemia Radiography Dual-Energy Scanned Projection Stroke medicine Humans Radiographic Image Interpretation Computer-Assisted Radiology Nuclear Medicine and imaging Neurology (clinical) Dual energy ct Tomography X-Ray Computed business Nuclear medicine Retrospective Studies |
| Zdroj: | Neuroradiol J |
| DOI: | 10.1177/19714009211047449 |
| Popis: | Background Virtual monoenergetic (VM) dual-energy computed tomography (DE-CT) enables grey-to-white matter contrast-to-noise ratio optimization, potentially increasing ischaemic brain oedema visibility. The aim of this study was to compare the diagnostic accuracy of VM and standard DE-CT reconstructions for early stroke detection. Methods Consecutive patients with non-contrast DE-CT of the brain scanned within 12 h of stroke symptom onset were prospectively included in the study. Patients with other significant brain pathology were excluded. Two radiologists jointly evaluated standard and VM reconstructions (from 40 to 190 keV at increments of 10 keV) for early stroke signs on a four-point Likert scale: (a) stroke definitely present, (b) stroke probably present, (c) probably no stroke, and (d) definitely no stroke. Follow-up imaging and clinical data served as the standard of reference. Diagnostic accuracy was evaluated by receiver operating characteristic analysis. Results Stroke incidence among 184 patients was 76%. In 64 patients follow-up imaging served as the standard of reference: ischemic brain oedema detection was significantly more accurate on VM reconstructions at 80 keV compared with standard DE-CT reconstructions (area under the curve (AUC) = 0.821 vs. AUC = 0.672, p = 0.002). The difference was most prominent within the first 3 h after symptom onset (at 11%, AUC = 0.819 vs. AUC = 0.709, p = 0.17) and in patients with National Institutes of Health Stroke Scale above 16 (at 37.5%, AUC = 1 vs. AUC = 0.625, p = 0.14). Conclusion VM DE-CT reconstructions at 80 keV appear to be the optimal non-contrast CT technique for diagnosing early ischaemic stroke, particularly within the first 3 h after symptom onset and in severely ill patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|