The Value of Quantitative Parameters on Virtual Non-Contrast and Water-Based Images of Brain Spectral CT in Early Diagnosing Intracranial Hemorrhage after Endovascular Treatment
Objective To explore the value of virtual non-contrast(VNC)and water-based images in the diagnosis of intracranial hemorrhage(ICH)after endovascular treatment with brain spectral CT.Methods 69 patients underwent spectral CT scanning immediately after the endovascular treatment were retrospectively enrolled in this study.Patients were divided into hemorrhagic group and non-hemorrhagic group based on the gold standards,which were 24-hour follow-up non-contrast CT examinations.The CT values and the water concentration of VNC images and water-based images were meas-ured.We had analyzed the consistency and receiver operating characteristic curves(ROC)of the diagnostic performance of VNC and water-based images.Two radiologists conducted subjective assessment on the VNC and water-based diagnostic con-fidence of ICH.Results The cut-off values were 52.9 HU for VNC and 1043.9 mg/cm3 for water-based images on ICH diagnose.The diagnostic results have strong consistency(k=0.964,P＜0.001).The above water density and VNC CT values were significantly correlated(r,=0.967,P＜0.001)according to the bivariate Spearman rank-sum test.The ROC curve analysis showed that the areas under the curves of water-based images and VNC images were both 0.974(95％CI:0.904～0.997),0.976(95％CI:0.906～0.998),respectively.The difference was not statistically significant(P＞0.05).The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of VNC in diagnosing ICH at the best cutoff value were 94.7％,96.0％,90.0％,98.0％,and 95.7％,respectively.The corresponding values for water density at the best cutoff were 94.7％,98.0％,94.7％,98.0％,and 97.1％,respectively.The combination of VNC and water-based images had a higher diagnostic confidence score(P＜0.05).Conclusion The quantitative analysis of water-based images and VNC images using spectral CT has a high diagnostic value for imaging ICH after endovascular treat-ment.The best cutoff values are a water density of 1043.9 mg/cm3 and a VNC-CT value of 52.9 HU.Combining VNC and water-based images can improve diagnostic sensitivity and increase diagnostic confidence.
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