Differentiation of hemorrhage from contrast enhancement using dual-layer spectral CT in patients transferred for acute stroke

Edwin Gulko; Sana Ali; William Gomes; Chirag Gandhi; Hasit Mehta

doi:10.1016/j.clinimag.2020.06.046

Differentiation of hemorrhage from contrast enhancement using dual-layer spectral CT in patients transferred for acute stroke

Clin Imaging. 2021 Jan:69:75-78. doi: 10.1016/j.clinimag.2020.06.046. Epub 2020 Jul 3.

Authors

Edwin Gulko¹, Sana Ali², William Gomes², Chirag Gandhi³, Hasit Mehta²

Affiliations

¹ Department of Radiology, Division of Neuroradiology, Westchester Medical Center, Valhalla, NY, United States of America. Electronic address: Edwin.Gulko@wmchealth.org.
² Department of Radiology, Division of Neuroradiology, Westchester Medical Center, Valhalla, NY, United States of America.
³ Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, United States of America.

PMID: 32683139
DOI: 10.1016/j.clinimag.2020.06.046

Abstract

Acute stroke patients transferred to thrombectomy capable centers (TCC), undergo a CT head exam upon arrival at the TCC to evaluate for ASPECTS decay and intracranial hemorrhage. In patients who received iodinated contrast prior to transfer, parenchymal enhancement may simulate hemorrhage on this post-transfer CT. We report two cases utilizing CT spectral imaging to differentiate between parenchymal contrast enhancement and hemorrhage in this setting. TCC may consider dual-energy or dual-layer (spectral) imaging for this patient cohort.

Keywords: CT spectral imaging; Stroke.

MeSH terms

Cerebral Hemorrhage* / diagnostic imaging
Contrast Media
Humans
Stroke* / diagnostic imaging
Thrombectomy
Tomography, X-Ray Computed

Substances

Contrast Media