Objective To investigate the value of dual-energy CT in the diagnosis of secondary cerebral hemorrhage after intravascular therapy in patients with acute ischemic stroke(AIS)and its significance of guiding clinical treatment.Methods The clinical data of 148 patients with AIS who received endovascular therapy from November 2019 to May 2022 were retrospectively analyzed.Intracerebral hemorrhage was examined by double-energy iodinated CT scan immediately after operation.The results of CT or MRI within 48～72 h after operation were used as the standard to evaluate the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of dual-energy CT in diagnosing early postoperative cerebral hemorrhage and contrast agent extravasation in AIS patients.Results Of these 148 patients,29 patients'dual-energy CT scan did not find intracerebral high-density imaging,without bleeding 48～72 hours after the reexamination.There were 119 patients with high density images on CT scan,69 patients with pure iodine-contrast agent extravasation were diagnosed by dual-energy CT,of which 4 patients had cerebral hemorrhage after reexamination,the negative prediction rate was 94.2%.Of 50 patients with contrast leakage complicated with intracerebral hemorrhage diagnosed by dual-energy CT,43 patients had intracerebral hemorrhage,the positive prediction rate was 100%.No bleeding was found in 7 patients,the false positive rate was 14%.The total prediction accuracy was 92.6%.Conclusions Dual-energy CT examination after AIS intravascular intervention has important diagnostic value for early differentiation of cerebral hemorrhage and iodide contrast extravasation,which is helpful to timely adjustment of clinical treatment and reduce the mortality and disability rates.
Acute ischemic strokeIntravascular interventional therapyDual-energy CTIntracranial hemorrhageExtravasation of contrast agent
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