Prediction of infarction development after endovascular stroke therapy with dual-energy computed tomography

Objectives

After intraarterial recanalisation (IAR), the haemorrhage and the blood-brain barrier (BBB) disruption can be distinguished using dual-energy computed tomography (DECT). The aim of the present study was to investigate whether future infarction development can be predicted from DECT.

Methods

DECT scans of 20 patients showing 45 BBB disrupted areas after IAR were assessed and compared with follow-up examinations. Receiver operator characteristic (ROC) analyses using densities from the iodine map (IM) and virtual non-contrast (VNC) were performed.

Results

Future infarction areas are denser than future non-infarction areas on IM series (23.44?±?24.86 vs. 5.77?±?2.77; p?p?p?17.13 HU; p?

Conclusions

Future infarction development after IAR can be reliably predicted with the IM series. The prediction of haemorrhages and of infarction size is less reliable.

Key Points

? The IM series (DECT) can predict future infarction development after IAR. ? Later haemorrhages can be predicted using the IM and the BW series. ? The volume of definable hypodense areas in VNC correlates with infarction volume.