Ces radiol. 2008, 62(4):395-402

Detection of intracranial bleeding: comparison of the virtual non-contrast imaging of dual-energy CT-angiography and "conventional" non-contrast CTOriginal article

Jiří Ferda¹, Thomas Flohr², Bernhard Schmidt², Milan Novák¹, František Šlauf¹, Hynek Mírka¹, Jan Baxa¹, Jana Horemužová¹, Alena Bednářová¹, Eva Ferdová¹, Boris Kreuzberg¹

¹ Radiodiagnostická klinika LF UK a FN, Plzeň

² Siemens Medical Solutions, CT division, Department of Research and Development, Forchheim, Deutschland

Aim: To compare diagnostic quality of brain imaging in patients with intracranial bleeding using virtual non-contrast images obtained during analysis of dual-energy CT with them acquired by the conventional way.

Method: 16 patients (mean age 51.1 y, range 34-75 y; 9 males, 7 females) with subarachnoid hemorrhage (SAH) were enrolled in the study. Virtual non-contrast images were reconstructed using DualEnergy software (Siemens, Forchheim, Germany). All examinations were executed after application of 60 ml of iodinated contrast agent with concentration of 400 mg of iodine per milliliter on dual-source CT equipment (Definition, Siemens, Forchheim, Germany). The data were acquired using two tube-detector systems: system A used 140 kV, system B 80 kV respectively. Both systems used collimation 2× (32 × 0.6 mm). All findings were compared with them resulted from evaluation of conventional non-contrast images obtained using collimation of 2× (32 × 0.6 mm) with reconstruction of 6 mm thick images. Virtual-non contrast images were evaluated by one radiologist (23 years of CT praxis) blinded to the clinical history of patients. Virtual non-contrast images were created by one radiologist (14 years of CT praxis) who evaluated conventional images.

Results: 3 cases of traumatic SAH, 2 cases of perimesencephalic SAH, 6 cases of SAH caused with ruptured aneurysm without intraventricular or without intracerebral bleeding, 4 cases of SAH caused with ruptured aneurysm complicated with intraventricular or with intracerebral bleeding and one case of SAH with intracerebral bleeding caused by dural arteriovenous shunt. The same extent and the same localization of bleeding was noted on both virtual and conventional non-contrast brain CT. Accuracy of the virtual non-contrast brain imaging reached 100%.

Conclusion: Virtual non-contrast brain imaging shows an alternative way of hemorrhage detection when the postcontrast imaging was performed using dual-energy CT and exhibits a potential to replace conventional non.-contrast brain imaging.

Keywords: dual-energy CT, intracranial bleeding, virtual imaging

Grants and funding:

Podpořeno výzkumným záměrem MSM 0021620819.

Accepted: October 15, 2008; Published: December 1, 2008  Show citation